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Individual

MRS. ELLEN J DIAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW, LSW

Contact information

Practice address
112 N BROAD ST, RM 821, PHILADELPHIA, PA 19102-1512
(215) 568-0860
(215) 568-0769
Mailing address
5823 CHEW AVE, PHILADELPHIA, PA 19138-1735
(215) 843-1166

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
PA SW 123695
PA

Other

Enumeration date
08/15/2008
Last updated
08/15/2008
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