Doctor Name: | MARK ALLEN VANHOOSE |
NPI Number: | 1609085992 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LISW |
License Number: | I.0027552 |
Business Practice Address: | 4431 Marketing Pl Groveport, OH - 431259556 |
Business Phone Number: | 6148362466 |
Business Fax Number: | |
Mailing Address: | 1208 Oakhill Ave, FAIRBORN |
State: | OH |
Postal Code: | 453245667 |
Phone Number: | 9378791830 |
Fax Number: | |
NPI Enumeration Date: | 05/22/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | I.0027552 |
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 |