Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | S0700596 | OH |
NPI | 1003047648 |
---|---|
Provider Name | Anne M Brady |
First Address | Columbus, OH 43220-7607 |
Second Address | Columbus, OH 43220-7607 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2009 |
Last Update Date | 19/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
08258 | (05) | OH |