Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | S2106881 | OH |
NPI | 1003406323 |
---|---|
Provider Name | Deliana Maris Peralta Fuentes |
First Address | Cincinnati, OH 45206-1922 |
Second Address | Cincinnati, OH 45206-1922 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2021 |
Last Update Date | 24/09/2021 |