Individual
MRS. GINA MARIE MATTIVI STANGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
24 VETERANS SQ, MEDIA, PA 19063-3155
(610) 744-2526
(610) 514-9849
Mailing address
24 VETERANS SQ, MEDIA, PA 19063-3155
(610) 744-2526
(610) 514-9849
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW017967
PA
Other
Enumeration date
10/24/2014
Last updated
09/19/2018
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