Basic Information
Provider Information
NPI: 1801009998
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BOHMLER
FirstName: JANICE
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential: LISW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 8970
Address2:  
City: TOLEDO
State: OH
PostalCode: 436230970
CountryCode: US
TelephoneNumber: 4194754449
FaxNumber: 4194793833
Practice Location
Address1: 4334 SECOR RD
Address2:  
City: TOLEDO
State: OH
PostalCode: 436234234
CountryCode: US
TelephoneNumber: 4194754449
FaxNumber: 4194793833
Other Information
ProviderEnumerationDate: 05/07/2007
LastUpdateDate: 11/10/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700XI6090OHY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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