Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | S-31870 | OH |
NPI | 1003080011 |
---|---|
Provider Name | Curtis Jerome Halsell |
First Address | Lebanon, OH 45036-3903 |
Second Address | Lebanon, OH 45036-9600 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2008 |
Last Update Date | 22/04/2008 |