Provider Demographics
NPI:1659704237
Name:RIETMULDER-STONE, JANCEY (LSW)
Entity Type:Individual
Prefix:
First Name:JANCEY
Middle Name:
Last Name:RIETMULDER-STONE
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 E PHILADELPHIA ST
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-1531
Mailing Address - Country:US
Mailing Address - Phone:717-309-9723
Mailing Address - Fax:
Practice Address - Street 1:301 E PHILADELPHIA ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-1531
Practice Address - Country:US
Practice Address - Phone:717-309-9723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-19
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW130594104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker