Individual
CLEMENTINE-AIMEE OBAMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CMSW,LCSWA
Contact information
Practice address
3012 FALSTAFF RD, RALEIGH, NC 27610-1813
(984) 329-8924
Mailing address
1706 ITHACA LN, RALEIGH, NC 27606-2728
(919) 527-3396
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
B001134
NC
104100000X
Social Worker
SW137721
PA
1041C0700X
Clinical Social Worker
P018759
NC
Other
Enumeration date
10/18/2023
Last updated
10/18/2023
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