Individual
KIMBERLY RUTH MASER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1100 GRAMPIAN BLVD, WILLIAMSPORT, PA 17701-1909
(570) 320-7525
(570) 320-7484
Mailing address
1201 GRAMPIAN BLVD, WILLIAMSPORT, PA 17701-1900
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW012863
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0073396490002
—
PA
01
—
235311
VALUE OPTIONS
PA
01
—
855174
HIGHMARK BLUE SHIELD
PA
Enumeration date
03/31/2006
Last updated
11/16/2018
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