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Individual

JOHNATHAN B SOUTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMSW

Contact information

Practice address
314 GROVE NECK RD, EARLEVILLE, MD 21919-3008
(855) 740-1921
Mailing address
2701 RENAISSANCE BLVD FL 4, KING OF PRUSSIA, PA 19406-2781

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
24025
MD

Other

Enumeration date
05/06/2022
Last updated
05/06/2022
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