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Individual
ELIZABETH DETWEILER
Active
Individual
ELIZABETH DETWEILER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAS, LCSW
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1413
NC
1041C0700X
Clinical Social Worker
Primary
C006918
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6112148
—
NC
Enumeration date
01/26/2007
Last updated
08/15/2010
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