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Individual
MRS. WENDY L CANTOR DOBO
Active
Individual
MRS. WENDY L CANTOR DOBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
J2553
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
032038000
MAGELLAN
OH
01
—
343178
VALUE OPTIONS - FACILITY
OH
Enumeration date
09/01/2006
Last updated
12/08/2011
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