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Individual
ROBERTA ANN RAELSON
Active
Individual
ROBERTA ANN RAELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34003544A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000325401
ANTHEM
IN
01
—
34003544A
LCSW
IN
Enumeration date
01/05/2006
Last updated
03/18/2021
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