Individual
MS. KATHLEEN ANN MINORA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1111 E END BLVD, WILKES BARRE, PA 18711-0030
(570) 824-3521
(570) 821-7299
Mailing address
1111 E END BLVD, WILKES BARRE, PA 18711-0030
(570) 824-3521
(570) 821-7299
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW008995L
PA
1041C0700X
Clinical Social Worker
CW019933
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SW008995L
SOCIAL WORK
PA
Enumeration date
07/31/2006
Last updated
04/08/2021
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