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General NPI Number Information
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NPI Number | 1548515455
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Entity Type | Individual
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Provider Name | MICHELLE M WHITFORD LISW
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Gender | Female
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Dates
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Enumeration Date | 07/17/2012
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Last Update Date | 07/17/2012
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Provider Practice Location Address
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Address Line | 43 E MAIN ST
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City | AMELIA
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State | OH
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Zip | 45102-1993
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Country | US
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Telephone | 513-947-7000
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Fax | 513-947-7050
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Provider Business Mailing Address
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Address Line | 1282 PEBBLE BROOKE TRL APT 2
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City | MILFORD
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State | OH
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Zip | 45150-4535
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Country | US
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Telephone | 513-947-7000
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Fax | 513-947-7050
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I.0900258
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License Number State | OH
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