Individual
DWANE QUINCY BUDHEAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
160 E ERIE AVE, PHILADELPHIA, PA 19134-1011
(267) 600-2031
Mailing address
4226 W THOMPSON ST, PHILADELPHIA, PA 19104-1026
(215) 667-7133
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
134752
PA
Other
Enumeration date
03/23/2018
Last updated
03/23/2018
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