Provider Demographics
NPI:1407948359
Name:D ALONZO, MARY ELIZABETH (SW)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ELIZABETH
Last Name:D ALONZO
Suffix:
Gender:F
Credentials:SW
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:ELIZABETH
Other - Last Name:MANAGLIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SW
Mailing Address - Street 1:8220 CASTOR AVENUE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19152
Mailing Address - Country:US
Mailing Address - Phone:215-728-4380
Mailing Address - Fax:267-350-4887
Practice Address - Street 1:8220 CASTOR AVENUE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19152
Practice Address - Country:US
Practice Address - Phone:215-728-4380
Practice Address - Fax:267-350-4887
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW012009L104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker