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Individual

JACELYN BLANK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.ED.

Contact information

Practice address
2064 E YORK ST, PHILADELPHIA, PA 19125-1635
(215) 427-2739
Mailing address
2064 E YORK ST, PHILADELPHIA, PA 19125-1635
(215) 427-2739

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Enumeration date
03/29/2012
Last updated
03/29/2012
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