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General NPI Number Information
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NPI Number | 1437652203
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Entity Type | Organization
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Legal Business Name | CHRISTINA M. CAVALIERE, LISW, LLC
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Dates
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Enumeration Date | 03/17/2018
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 860 ANSONIA ST STE 13A
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City | OREGON
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State | OH
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Zip | 43616-3177
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Country | US
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Telephone | 419-320-7944
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Fax |
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Provider Business Mailing Address
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Address Line | 10649 BROWN RD
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City | CURTICE
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State | OH
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Zip | 43412-9416
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Country | US
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Telephone | 419-329-7944
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Fax |
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Authorized Official
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Title or Position | CLINICAL THERAPIST
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Name | CHRISTINA MARIA CAVALIERE
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Credential | LISW
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Telephone | 419-320-7944
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I.1200987
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License Number State | OH
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