Individual
MRS. AUDREY J. ENNIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LSW
Contact information
Practice address
6 E RIDGE RD, MEDIA, PA 19063-2541
(610) 565-2646
Mailing address
6 E RIDGE RD, MEDIA, PA 19063-2541
(610) 565-2646
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW126841
PA
Other
Enumeration date
02/21/2009
Last updated
02/21/2009
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