Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | S.0024621 | OH |
NPI | 1003220112 |
---|---|
Provider Name | Mrs. Marilyn P Sanderfer |
First Address | Dayton, OH 45417-3424 |
Second Address | Dayton, OH 45417-3424 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2014 |
Last Update Date | 17/06/2014 |