Provider Demographics
NPI:1447815352
Name:FERGUSON, ANTOINETTE (MSW)
Entity type:Individual
Prefix:
First Name:ANTOINETTE
Middle Name:
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25D CONGRESSIONAL CIR
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19607-3463
Mailing Address - Country:US
Mailing Address - Phone:610-372-2913
Mailing Address - Fax:
Practice Address - Street 1:25D CONGRESSIONAL CIR
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19607-3463
Practice Address - Country:US
Practice Address - Phone:610-372-2913
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-06
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW135218104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker