Individual
JASPER Y LIEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1417 LOCUST STREET, 2ND FLOOR, PHILADELPHIA, PA 19102-3989
(215) 344-1632
(215) 564-8606
Mailing address
1233 LOCUST ST, 3RD FLOOR, PHILADELPHIA, PA 19107-5453
(215) 985-4448
(215) 985-4952
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW018945
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103110671
—
PA
Enumeration date
10/03/2013
Last updated
03/17/2018
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