Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | I 1450748 | OH |
NPI | 1003264466 |
---|---|
Provider Name | Lisa Allison |
First Address | Chagrin Falls, OH 44023-5486 |
Second Address | Chagrin Falls, OH 44023-5486 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2016 |
Last Update Date | 26/05/2016 |