Individual
JACLYN M SCANLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
5350 LAMME RD, MORAINE, OH 45439-3215
(937) 534-4632
(937) 534-4609
Mailing address
1532 LITTLE FALLS DR, DAYTON, OH 45458-9707
(315) 269-4261
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I0800313
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000611131
ANTHEM
OH
Enumeration date
04/03/2009
Last updated
06/21/2024
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