Individual
ETHAN S BLADES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2641 N 6TH ST, PHILADELPHIA, PA 19133-2637
(215) 291-9700
(215) 291-0626
Mailing address
1216 ARCH ST, 6TH FLOOR, PHILADELPHIA, PA 19107-2835
(215) 981-0088
(215) 864-6931
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
04/02/2009
Last updated
04/02/2009
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