Individual
DJUAN DESHONGE SHORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
104 S 20TH ST STE V30, PHILADELPHIA, PA 19103-4410
(267) 225-2630
Mailing address
104 S 20TH ST STE V30, PHILADELPHIA, PA 19103-4410
(267) 225-2630
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
44SC06129200
NJ
1041C0700X
Clinical Social Worker
Primary
CW020719
PA
Other
Enumeration date
04/14/2020
Last updated
02/07/2025
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