Individual
AARON BLAINE DETWILER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, LCSW
Contact information
Practice address
1930 W LINCOLN AVE, GOSHEN, IN 46526-5907
(574) 534-2161
(574) 534-3887
Mailing address
1930 W LINCOLN AVE, GOSHEN, IN 46526-5907
(574) 534-2161
(574) 534-3887
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34006654A
IN
Other
Enumeration date
01/31/2013
Last updated
01/31/2013
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