NPI 1194009035

Elise D Daxe

Practitioner Clinical Social Worker Portage, IN

Practice location

Address: 3176 Lancer St, Portage, IN 46368-4408
Phone: (219) 762-9557
Mailing address: 601 Wall St, Valparaiso, IN 46383-2512

Registered specialties

Clinical Social Worker Primary

Behavioral Health & Social Service Providers Taxonomy 1041C0700X Licence 34006342A (IN)

Other Social Worker providers in Indiana →

Registry record

NPI: 1194009035
Entity type: Individual
Sex (as registered): Female
NPI issued: 10 Oct 2011
Record last updated: 10 Oct 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.