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Individual

DARYA SOUDMAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSSA, LSW

Contact information

Practice address
3737 LANDER RD, PEPPER PIKE, OH 44124-5712
(216) 831-2255
Mailing address
3737 LANDER RD, PEPPER PIKE, OH 44124-5712
(216) 831-2255

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
S.1600996
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2871101
OH
Enumeration date
12/12/2014
Last updated
10/11/2016
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