Doctor Name: | DOUGLAS PAUL PANNETTE |
NPI Number: | 1275518896 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LISW-S |
License Number: | 6801059153 |
Business Practice Address: | 8000 Town Centre Dr Suite 300 Broadview Heights, OH - 441474030 |
Business Phone Number: | 4406276962 |
Business Fax Number: | 4406276963 |
Mailing Address: | 10020 Lynn Dr, NORTH ROYALTON |
State: | OH |
Postal Code: | 441331424 |
Phone Number: | 2164060825 |
Fax Number: | |
NPI Enumeration Date: | 12/07/2005 |
NPI Last Update Date: | 03/13/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 6801059153 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |