Doctor Name: | KACIE HOUSEHOLDER |
NPI Number: | 1528455524 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | S.1303313 |
Business Practice Address: | 520 Youngstown Poland Rd Struthers, OH - 444711103 |
Business Phone Number: | 3303183078 |
Business Fax Number: | |
Mailing Address: | 775 Althea Ave Nw, WARREN |
State: | OH |
Postal Code: | 444832235 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 04/17/2015 |
NPI Last Update Date: | 04/17/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | S.1303313 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |