Provider Demographics
NPI:1194183632
Name:DELGADO, DIONNE ALICIA (MSW /LSW)
Entity Type:Individual
Prefix:
First Name:DIONNE
Middle Name:ALICIA
Last Name:DELGADO
Suffix:
Gender:F
Credentials:MSW /LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6327 BURBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19144-2505
Mailing Address - Country:US
Mailing Address - Phone:215-991-9066
Mailing Address - Fax:215-991-9062
Practice Address - Street 1:6327 BURBRIDGE ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144-2505
Practice Address - Country:US
Practice Address - Phone:215-991-9066
Practice Address - Fax:215-991-9062
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-28
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW130970104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty