Individual
KANEISHA VIRGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
700 S CHESTER RD, SWARTHMORE, PA 19081-2224
(484) 479-3475
Mailing address
32 FAIRVIEW AVE, YEADON, PA 19050-2826
(267) 265-8475
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW133867
PA
Other
Enumeration date
12/13/2016
Last updated
12/13/2016
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