Individual
ELISSA NICHOLE HOSTETTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3095 KETTERING BLVD, MORAINE, OH 45439-1983
(937) 534-1384
Mailing address
1975 SPRINGWOOD DR, PIQUA, OH 45356-7527
(304) 479-2721
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
S1201277
OH
Other
Enumeration date
11/05/2012
Last updated
11/05/2012
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