Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | S.1903595 | OH |
NPI | 1003471970 |
---|---|
Provider Name | Mrs. Theresa Michelle Lanier |
First Address | Columbus, OH 43215-5602 |
Second Address | Columbus, OH 43215-5602 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2019 |
Last Update Date | 30/05/2019 |