Individual
ELISABETH OLDMIXON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
171 MARKET SQ STE 206B, NEWINGTON, CT 06111-2930
(617) 816-9011
Mailing address
3409 LASSITER FALLS CIR, RALEIGH, NC 27609-6973
(201) 725-0639
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
104100000X
Social Worker
Primary
44SL05399600
NJ
Other
Enumeration date
04/01/2024
Last updated
05/07/2024
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