Individual
MRS. GENEVA OSAWE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LMFT
Contact information
Practice address
5825 BROADWAY, SUITE D, MERRILLVILLE, IN 46410-2687
(219) 980-4330
(219) 980-9119
Mailing address
5825 BROADWAY, SUITE D, MERRILLVILLE, IN 46410-2687
(219) 980-4330
(219) 980-9119
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34000001
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202580
MEDICARE-TYPE UNSPECIFIED
IN
01
—
9001137
BLUE CROSS & SHIELD IL
IL
Enumeration date
09/04/2007
Last updated
09/04/2007
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