Individual
MR. JODI L IPPOLITO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.C.S.W.
Contact information
Practice address
313 S 16TH ST, PHILADELPHIA, PA 19102-4908
(215) 732-8244
Mailing address
305 E UPSAL ST, PHILADELPHIA, PA 19119-2348
(267) 974-4259
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW015185
PA
Other
Enumeration date
12/21/2006
Last updated
07/08/2007
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