Kim P Staneluis, LISW LICDC

NPI #1770657579 in Maumee, Ohio

Provider Information

NPI Number: 1770657579
Entity Type: Individual
Name: Kim P Staneluis, LISW LICDC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker
Credential: LISW LICDC
Enumeration Date: Nov 20, 2006
Last Updated: Jun 14, 2011

Practice Location

Address: 109 W WAYNE ST
City: Maumee
State: Ohio
ZIP Code: 43537-2150
Phone: (419) 893-8432

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X	Primary

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