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NPI Code Detail

MEDICARE: PATRICIA E GRISWOLD MSW, LISW

MEDICARE: PATRICIA E GRISWOLD MSW, LISW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerI0004562OH

General Provider Information

NPI Number : 1326281254
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA E GRISWOLD MSW, LISW
Provider Business Mailing Address
First Line : 9916 SHAWNEE TRL
Second Line :
City : CENTERVILLE
State : OH
Zip : 45458-4064
Country : US
Telephone Number : 937-885-5105
Fax Number : 937-528-6896
Provider Business Practice Location Address
First Line : 2132 E 3RD ST
Second Line :
City : DAYTON
State : OH
Zip : 45403-1991
Country : US
Telephone Number : 937-528-6850
Fax Number : 937-528-6896
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2009
Last Update Date : 04/08/2009

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