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Individual
MS. STACY M MANDATO
Active
Individual
MS. STACY M MANDATO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSSA, LSW
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
S1000364
OH
1041C0700X
Clinical Social Worker
Primary
I.1801296-SUPV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2069738
—
OH
Enumeration date
02/03/2011
Last updated
03/28/2022
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