Individual
MRS. JANET A SHADID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
639 LUZERNE ST, JOHNSTOWN, PA 15905-2327
(814) 536-0798
(814) 536-5746
Mailing address
639 LUZERNE ST, JOHNSTOWN, PA 15905-2327
(814) 536-0798
(814) 536-5746
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
122484
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1418791
BLUE CROSS PROVIDER #
PA
Enumeration date
07/01/2006
Last updated
07/08/2007
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