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Individual

MS. GEORGIA LYNN FULGENZI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
L.C.S.W.

Contact information

Practice address
1 WILLIAMSBURG PL, #220, WARRENDALE, PA 15086-7540
(724) 814-9521
Mailing address
500 INDIAN PINE LN, WEXFORD, PA 15090-7594
(724) 935-7143

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW016031
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
102769256 0002
PA
01
627369
HIGHMARK PROVIDER NUMBER
PA
Enumeration date
07/25/2006
Last updated
07/05/2016
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