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General NPI Number Information
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NPI Number | 1629321005
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Entity Type | Individual
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Provider Name | JOY L WITWER LISW-SUPV
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Gender | Female
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Dates
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Enumeration Date | 10/22/2012
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Last Update Date | 11/06/2023
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Provider Practice Location Address
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Address Line | 93 W FRANKLIN ST STE 105
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City | CENTERVILLE
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State | OH
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Zip | 45459-4761
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Country | US
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Telephone | 937-602-0501
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Fax | 937-249-6727
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Provider Business Mailing Address
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Address Line | 93 W FRANKLIN ST STE 105
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City | CENTERVILLE
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State | OH
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Zip | 45459-4761
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Country | US
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Telephone | 937-602-0501
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Fax | 937-249-6727
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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 | I0008404-SUPV
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License Number State | OH
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