Most Relevant Information
Provider Data
| NPI Number: | 1003458464 |
| Provider Name: | GEORGIA LOUGHLIN LSMW |
| Entity Type: | Individual |
| Taxonomy Code: | 104100000X |
| Specialty: | Social Worker |
| License Number: | 107759-01 |
Most Important Dates
| Enumeration Date: | 10/16/2019 |
| Last Updated: | 10/16/2019 |
Provider Practice Location
536 KAPPOCK ST APT 6E
BRONX
NY
104636451
Practice Location Phone/Fax
| Phone: | 8455148824 |
| Fax: |
Provider Mailing Location
536 KAPPOCK ST APT 6E
BRONX
NY
104636451
Provider Mailing Phone/Fax
| Phone: | 8455148824 |
| Fax: |