Provider Demographics
NPI:1073251633
Name:AGOSTINI, DOROTHY GWENDOLYN (BSW)
Entity Type:Individual
Prefix:MRS
First Name:DOROTHY
Middle Name:GWENDOLYN
Last Name:AGOSTINI
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 LOPAX RD APT J13
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-4507
Mailing Address - Country:US
Mailing Address - Phone:223-240-2543
Mailing Address - Fax:
Practice Address - Street 1:3030 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-2518
Practice Address - Country:US
Practice Address - Phone:717-273-8000
Practice Address - Fax:717-273-8244
Is Sole Proprietor?:No
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator