Individual
CORETTA DANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
S.1303660
OH
104100000X
Social Worker
Primary
S.1303660
OH
1041C0700X
Clinical Social Worker
S.1303660
OH
Other
Enumeration date
01/24/2023
Last updated
05/28/2024
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