Individual
CLARICE COLWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
65 N WASHINGTON ST STE 1, WILKES BARRE, PA 18701-3119
(570) 331-8400
Mailing address
20 STADIUM ST, EXETER, PA 18643-2623
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW136881
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497252100
—
PA
Enumeration date
03/04/2024
Last updated
03/04/2024
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