Individual
MRS. BEVERLY VELASQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
S.W.
Contact information
Practice address
3900 WOODLAND AVE, PHILADELPHIA, PA 19104-4551
(215) 823-5800
Mailing address
7270 LAMPORT RD, UPPER DARBY, PA 19082-5111
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
CW019925
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31-1575142
—
PA
05
—
311575142
—
PA
05
—
CW019925
—
PA
Enumeration date
08/30/2006
Last updated
11/17/2020
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