Individual
DOUGLAS PAUL PANNETTE
Active
Individual
DOUGLAS PAUL PANNETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LISW-S
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
6801059153
MI
1041C0700X
Clinical Social Worker
Primary
I0008711
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
094872000
MAGELLAN MIS
OH
01
—
515293
VALUE OPTIONS
OH
Enumeration date
12/07/2005
Last updated
03/13/2013
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