Individual
DESE'RAE LYNN STAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW,MSW
Contact information
Practice address
701 E CATHEDRAL RD STE 45-1395, PHILADELPHIA, PA 19128-2128
(267) 532-4494
Mailing address
2310 MERCER ST, PHILADELPHIA, PA 19125-3625
(646) 284-0618
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
CW025097
PA
Other
Enumeration date
06/01/2022
Last updated
10/01/2024
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