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General NPI Number Information
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NPI Number | 1336383827
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Entity Type | Individual
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Provider Name | JOSIE R MUTERSPAW PCC
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Gender | Female
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Dates
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Enumeration Date | 04/28/2009
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Last Update Date | 04/28/2009
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Provider Practice Location Address
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Address Line | 7565 N STATE ROUTE 42
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City | WAYNESVILLE
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State | OH
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Zip | 45068-8841
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Country | US
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Telephone | 937-728-3397
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Fax |
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Provider Business Mailing Address
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Address Line | 9255 HERITAGE GLEN DR
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City | MIAMISBURG
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State | OH
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Zip | 45342-7410
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Country | US
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Telephone | 937-838-0770
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | E 0500725
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License Number State | OH
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