Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | S.1802325 | OH |
NPI | 1003314683 |
---|---|
Provider Name | Emily Ashton Keckler |
First Address | Lima, OH 45804-1500 |
Second Address | Lima, OH 45804-1500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2018 |
Last Update Date | 12/12/2019 |