Individual
MRS. JAMIE MARIE MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
793 OLD ROUTE 119 HWY N, INDIANA, PA 15701-1372
(724) 465-5576
(724) 463-3262
Mailing address
793 OLD ROUTE 119 HWY N, INDIANA, PA 15701-1372
(724) 465-5576
(724) 463-3262
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
SW122446
PA
1041C0700X
Clinical Social Worker
Primary
CW018991
PA
Other
Enumeration date
09/30/2005
Last updated
05/16/2016
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