Provider Demographics
NPI:1336222777
Name:BACH, ANA ISABEL (LSW)
Entity Type:Individual
Prefix:MS
First Name:ANA
Middle Name:ISABEL
Last Name:BACH
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:ANA
Other - Middle Name:ISABEL
Other - Last Name:MARTOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
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:215-728-4648
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:215-728-4648
Practice Address - Fax:267-350-4887
Is Sole Proprietor?:No
Enumeration Date:2006-10-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW125522104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker