Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker |
NPI | 1003307323 |
---|---|
Provider Name | Keely Marie Galluzzo |
First Address | Cincinnati, OH 45244-1447 |
Second Address | Cincinnati, OH 45244-1551 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2018 |
Last Update Date | 17/07/2019 |