Individual
CASEY IVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
525 LAKE AVE, ASHTABULA, OH 44004-3261
(440) 536-5680
Mailing address
695 SOUTH ST STE 6, CHARDON, OH 44024-1474
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
S.1903863
OH
Other
Enumeration date
09/10/2018
Last updated
07/13/2021
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