Individual
MRS. LINA MARIO PULIDO-RAMIREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
34006696A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000839292
ANTHEM
IN
01
—
527078
MHN/TRICARE
IN
01
—
P01303019
MEDICARE RAILROAD
IN
Enumeration date
05/01/2007
Last updated
07/10/2014
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