Individual
JACQUELINE RUSSAK-LOFTUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
727 OLD WELSH RD, HUNTINGTON VALLEY, PA 19006
(215) 914-2119
Mailing address
1142 LINDBERGH AVE, FEASTERVILLE TREVOSE, PA 19053-4139
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW016784
PA
Other
Enumeration date
05/31/2016
Last updated
05/31/2016
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