Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 0030307 | OH |
NPI | 1003319849 |
---|---|
Provider Name | Catalina Thompson |
First Address | Kent, OH 44240-8100 |
Second Address | Lima, OH 45804-1519 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2018 |
Last Update Date | 16/03/2018 |