Individual
MR. KENRICK WADSWORTH HACKETT JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1489 BALTIMORE PIKE STE 200, SPRINGFIELD, PA 19064-3958
(610) 604-9510
Mailing address
5971 DREXEL RD, PHILADELPHIA, PA 19131-1215
(215) 877-8598
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW015978
PA
Other
Enumeration date
08/10/2008
Last updated
08/10/2008
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