| NPI | 1487136743 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA M BLACKWELL Owner 419-973-7029 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I.0007485) |
| Enumeration Date | 2018-09-04 |
| Last Update Date | 2019-07-12 |