Individual
EDIE HENTHORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
6140 S BROADWAY, LORAIN, OH 44053-3891
(440) 233-7232
Mailing address
6140 S BROADWAY, LORAIN, OH 44053-3891
(440) 233-7232
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
S.1802416
OH
1041C0700X
Clinical Social Worker
Primary
I2002483
OH
Other
Enumeration date
04/13/2016
Last updated
02/11/2021
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