Individual
BURGANDY DESIRE HOLIDAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
850 W LANCASTER AVE, 2ND FLOOR, BRYN MAWR, PA 19010-3220
(610) 520-1510
(610) 520-1517
Mailing address
1732 N 60TH ST, PHILADELPHIA, PA 19151-3909
(215) 284-9107
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW130834
PA
Other
Enumeration date
04/25/2014
Last updated
04/25/2014
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