Individual
ANYA L MACK
Active
Individual
ANYA L MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW-S
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I1500756SUPV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0194566
—
OH
Enumeration date
02/15/2011
Last updated
05/09/2018
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