Individual
MS. IDELLE DATLOF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
420 W LOVELAND AVE, LOVELAND, OH 45140-2368
(513) 300-0566
Mailing address
6833 SPRINGCREST CIR, CINCINNATI, OH 45243-2435
(513) 793-4745
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I.0900034
OH
Other
Enumeration date
02/23/2009
Last updated
03/04/2009
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