WANDA SOCORRO ORTIZ THAYNE

BEAVERCREEK, OH
NPI1417415464
Former NameWANDA S ORTIZ CAMINITE
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: UT  98196273501)
Additional Taxonomies1041C0700X Social Worker, Clinical
(Licence: SC  6307)
1041C0700X Social Worker, Clinical
(Licence: CA  LCSW13132)
1041C0700X Social Worker, Clinical
(Licence: NM  C2154)
Enumeration Date2019-03-08
Last Update Date2019-03-08
Business Address
WANDA SOCORRO ORTIZ THAYNE LCSW
4199 SPRUCE WOOD DR
BEAVERCREEK, OH 45432-4124
Phone number: 808-295-7362
Mailing Address
WANDA SOCORRO ORTIZ THAYNE LCSW
4199 SPRUCE WOOD DR
BEAVERCREEK, OH 45432-4124
Phone number: 808-295-7362