Basic Information
| Provider Information | |||||||||
| NPI: | 1932613544 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COOMBS | ||||||||
| FirstName: | KAREN | ||||||||
| MiddleName: | ANNE | ||||||||
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| Credential: | BSW, LSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1219 JEFFERSON AVE | ||||||||
| Address2: | |||||||||
| City: | TOLEDO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436045836 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4192212821 | ||||||||
| FaxNumber: | 4192212821 | ||||||||
| Practice Location | |||||||||
| Address1: | 1219 JEFFERSON AVE | ||||||||
| Address2: | |||||||||
| City: | TOLEDO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436045836 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4192212821 | ||||||||
| FaxNumber: | 4192212824 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/20/2017 | ||||||||
| LastUpdateDate: | 02/16/2018 | ||||||||
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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 | 104100000X | S1600630 | OH | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.