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Individual

MRS. HOLLY AILEEN DISCH STODDARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSSA, LISW

Contact information

Practice address
398 W BAGLEY RD STE 13, BEREA, OH 44017-1312
(440) 970-3790
(440) 527-8043
Mailing address
398 W BAGLEY RD STE 13, BEREA, OH 44017-1312
(440) 970-3790
(440) 527-8043

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I.2405411
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0448980
OH
Enumeration date
08/31/2020
Last updated
08/21/2024
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