1447478490 NPI number — MICHAELINE JOYCE WALSH MSW

Table of content: MICHAELINE JOYCE WALSH MSW (NPI 1447478490)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447478490 NPI number — MICHAELINE JOYCE WALSH MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WALSH
Provider First Name:
MICHAELINE
Provider Middle Name:
JOYCE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447478490
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4841 MONROE STREET
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
TOLEDO
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43623
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
417-475-2535
Provider Business Mailing Address Fax Number:
419-475-0881

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4841 MONROE STREET
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
TOLEDO
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43623
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-475-2535
Provider Business Practice Location Address Fax Number:
419-475-0881
Provider Enumeration Date:
04/23/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , with the licence number:  0004658 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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