Individual
JOHN RUSSELL ELSASSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, LCSW
Contact information
Practice address
118 N SALLY DR, WINAMAC, IN 46996-9100
(574) 946-4233
(574) 946-4365
Mailing address
118 N SALLY DR, WINAMAC, IN 46996-9100
(574) 946-4233
(574) 946-4365
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34003534A
IN
Other
Enumeration date
08/01/2012
Last updated
08/01/2012
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