Provider Demographics
NPI:1487663209
Name:MARMORA, VERONICA (LCSW, ACSW)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:MARMORA
Suffix:
Gender:F
Credentials:LCSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 GORDON DR
Mailing Address - Street 2:SUITE # 205
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-1322
Mailing Address - Country:US
Mailing Address - Phone:610-594-6303
Mailing Address - Fax:810-592-6303
Practice Address - Street 1:255 GORDON DR
Practice Address - Street 2:SUITE # 205
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-1322
Practice Address - Country:US
Practice Address - Phone:610-594-6303
Practice Address - Fax:810-592-6303
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0135341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical