Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | I0002533SUPV | OH |
NPI | 1003246703 |
---|---|
Provider Name | Ms. Cristina Carol Brubaker |
First Address | Dublin, OH 43017-2377 |
Second Address | Dublin, OH 43017-2377 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2013 |
Last Update Date | 15/11/2013 |