Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | S 1440399 | OH |
NPI | 1003293895 |
---|---|
Provider Name | Sally Raterman |
First Address | Columbus, OH 43223-2616 |
Second Address | Columbus, OH 43223-2616 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2015 |
Last Update Date | 30/04/2015 |