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Individual
MARY E WHITE
Active
Individual
MARY E WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I1302759
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
I1302759
SOCIAL WORK LISCENSE
OH
Enumeration date
11/03/2015
Last updated
11/03/2015
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