Individual
DAVID ELDON CLEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
S1501112
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S1501112
SOCIAL WORKER LICENCE
OH
Enumeration date
12/13/2017
Last updated
12/13/2017
Update your record
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