Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | S1802958 | OH |
NPI | 1003398314 |
---|---|
Provider Name | Hannah Moag |
First Address | Highland Hills, OH 44128-2811 |
Second Address | Highland Hills, OH 44128-2811 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2018 |
Last Update Date | 04/09/2018 |