Elise D Daxe

NPI #1194009035 in Portage, Indiana

Provider Information

NPI Number: 1194009035
Entity Type: Individual
Name: Elise D Daxe
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Social Worker - Clinical
Enumeration Date: Oct 10, 2011
Last Updated: Oct 10, 2011

Practice Location

Address: 3176 LANCER ST
City: Portage
State: Indiana
ZIP Code: 46368-4408
Phone: (219) 762-9557

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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