Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 1450939 | OH |
NPI | 1003300641 |
---|---|
Provider Name | Stephanie Wahl |
First Address | Zanesville, OH 43701-0815 |
Second Address | Zanesville, OH 43701-0815 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2018 |
Last Update Date | 18/06/2018 |