Individual
JACOB KOFFLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
1700 SANSOM ST FL 11, PHILADELPHIA, PA 19103-5245
(914) 261-4370
Mailing address
1116 S 47TH ST APT 2, PHILADELPHIA, PA 19143-3615
(914) 261-4370
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW141020
PA
Other
Enumeration date
12/05/2023
Last updated
12/05/2023
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