Individual
ANITA SHADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
602 1ST ST, DU BOIS, PA 15801-3016
(570) 404-0010
Mailing address
602 1ST ST, DU BOIS, PA 15801-3016
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW141736
PA
Other
Enumeration date
07/16/2024
Last updated
07/18/2024
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