Individual
JASON LEE ANTHONY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
340 MONTAGE MOUNTAIN RD, MOOSIC, PA 18507-1707
(570) 346-3686
Mailing address
340 MONTAGE MOUNTAIN RD, MOOSIC, PA 18507-1707
(570) 346-3686
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
ASW106094
CA
104100000X
Social Worker
Primary
SW141008
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ASW106094
CA BBS
CA
Enumeration date
09/09/2020
Last updated
03/07/2024
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