Individual
MRS. KORLU EZIKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1220 SUGARBERRY LN, COLLEGEVILLE, PA 19426-2886
(267) 246-2687
Mailing address
3125 RIDGE PIKE, EAGLEVILLE, PA 19403-5708
(610) 630-2111
(610) 630-4003
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW010122
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
665666
—
PA
Enumeration date
03/14/2018
Last updated
08/26/2021
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