Individual
MISTY C POOLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW,LSW
Contact information
Practice address
115 FARABEE DR N STE C, LAFAYETTE, IN 47905-5933
(765) 412-9267
Mailing address
115 FARABEE DR N STE C, LAFAYETTE, IN 47905-5933
(765) 412-9267
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
99036186A
IN
Other
Enumeration date
02/18/2009
Last updated
02/18/2009
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