Individual
MS. AMY KATHARINE VACCARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSS LCSW
Contact information
Practice address
205 N. MONROE ST., MEDIA, PA 19063
(610) 566-3484
(610) 672-9814
Mailing address
205 N MONROE ST, MEDIA, PA 19063-3052
(610) 566-3484
(610) 672-9814
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW014201
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101791815
—
PA
Enumeration date
10/03/2006
Last updated
08/17/2012
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