Individual
MS. ALICE MICHELE WEAVER MACZUGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
816 CENTRAL ROAD, BOLLMSBURG, PA 17815
(570) 387-1832
(570) 387-5103
Mailing address
816 CENTRAL ROAD, BOLLMSBURG, PA 17815
(570) 387-1832
(570) 387-5103
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW126868
PA
Other
Enumeration date
06/20/2012
Last updated
06/20/2012
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