Individual
MIA BEZALEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
6120B WOODLAND AVE 2ND FL, PHILADELPHIA, PA 19142-3224
(215) 727-4721
(267) 350-5932
Mailing address
4700 WISSAHICKON AVE STE 118, PHILADELPHIA, PA 19144-4248
(267) 597-3600
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102694997
—
PA
Enumeration date
03/28/2012
Last updated
09/08/2021
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