Basic Information
Provider Information
NPI: 1154792869
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOWARD
FirstName: DONNA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MA, LPCC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 544 E WOODRUFF AVE
Address2:  
City: TOLEDO
State: OH
PostalCode: 436045342
CountryCode: US
TelephoneNumber: 4196930631
FaxNumber:  
Practice Location
Address1: 544 E WOODRUFF AVE
Address2:  
City: TOLEDO
State: OH
PostalCode: 436045342
CountryCode: US
TelephoneNumber: 4196930631
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/08/2015
LastUpdateDate: 11/01/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YA0400XICDC.141232-3OHY Behavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
101YM0800XE.1300356OHN Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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