| NPI | 1093281065 |
|---|---|
| Other Name | ETTA LOUISE CHARLEBOIS LISW-S |
| Entity Type | Organization |
| Authorized Contact | ETTA LOUISE CHARLEBOIS Clinical Social Worker 937-712-2438 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2018-10-17 |
| Last Update Date | 2020-08-01 |