Provider Demographics
NPI:1649595570
Name:COMO, JODY B (MS,S, , LSW)
Entity Type:Individual
Prefix:MRS
First Name:JODY
Middle Name:B
Last Name:COMO
Suffix:
Gender:F
Credentials:MS,S, , LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2288 2ND STREET PIKE STE 6
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-4108
Mailing Address - Country:US
Mailing Address - Phone:215-598-9020
Mailing Address - Fax:
Practice Address - Street 1:2288 2ND STREET PIKE STE 6
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-4108
Practice Address - Country:US
Practice Address - Phone:215-598-9020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-04
Last Update Date:2010-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW122890104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker