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1194009035
ELISE D DAXE
PORTAGE, IN
NPI
1194009035
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Former Name
ELISE D DAXE-PULLINS
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: IN 34006342A)
Enumeration Date
2011-10-10
Last Update Date
2011-10-10
Business Address
-- ELISE D DAXE
3176 LANCER ST
PORTAGE, IN 46368-4408
Phone number: 219-762-9557
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Mailing Address
-- ELISE D DAXE
601 WALL ST
VALPARAISO, IN 46383-2512
Phone number: 219-531-3500
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