Basic Information
| Provider Information | |||||||||
| NPI: | 1578882023 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GHESQUIRE | ||||||||
| FirstName: | LYNN | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | MSW, LSW, LICDC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 544 E WOODRUFF AVE | ||||||||
| Address2: | |||||||||
| City: | TOLEDO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436045342 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4192429577 | ||||||||
| FaxNumber: | 4199367606 | ||||||||
| Practice Location | |||||||||
| Address1: | 544 E WOODRUFF AVE | ||||||||
| Address2: | |||||||||
| City: | TOLEDO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436045342 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4192429577 | ||||||||
| FaxNumber: | 4199367606 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2010 | ||||||||
| LastUpdateDate: | 09/18/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | ICDC.081139 | OH | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 1041C0700X | I.1451338 | OH | N | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.