Individual
EILEEN B ADDIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4100 MAIN ST STE 403, PHILADELPHIA, PA 19127-1623
(215) 487-3000
Mailing address
670 MALLARD RD, WAYNE, PA 19087-2344
(610) 247-8504
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW018387
PA
Other
Enumeration date
01/18/2018
Last updated
07/05/2024
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