Audrey J. Ennis | Media, PA • PECOS Search

Audrey J. Ennis

Social Worker

Behavioral Health & Social Service Providers

6 E Ridge Rd, Media, PA 19063-2541

PECOS Enrollment

Based on the most recent information from CMS, provider Audrey J. Ennis does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1922248541
Provider Type
Individual
Full Name
Ennis, Audrey J.
Title
Mrs.
Credential
MSW, LSW

Gender
Female
Sole Proprietor
Yes
Enumeration Date
2/21/2009
Last Updated
2/21/2009

Contact Information

Practice Location

6 E Ridge Rd, Media, PA 19063-2541

Unlisted Fax

Mailing Location

6 E Ridge Rd, Media, PA 19063-2541

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License SW126841 Pennsylvania