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Individual
MS. MARY ELLEN PATTON
Active
Individual
MS. MARY ELLEN PATTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904003758
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004945395
PROVIDER NUMBER
VA
05
—
004945395
—
VA
01
—
288130
PROVIDER NUMBER
VA
01
—
O89523
PROVIDER NUMBER
VA
Enumeration date
10/24/2006
Last updated
02/01/2019
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