Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | S0901306 | OH |
NPI | 1003146085 |
---|---|
Provider Name | Stephanie Lyn Page |
First Address | Sylvania, OH 43560-2155 |
Second Address | Sylvania, OH 43560-2155 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/01/2010 |
Last Update Date | 13/01/2010 |