Individual
MS. MARY RITA FENNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
23284 BRIDGEWAY DR WEST, LEWES, DE 19958
(845) 532-5947
Mailing address
23284 BRIDGEWAY DR WEST, LEWES, DE 19958
(845) 532-5947
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
077917
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Q1-0001404
LCSW
DE
Enumeration date
06/06/2007
Last updated
10/16/2015
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