1215449871 NPI number — MARY T. THURLOW-COLLEN CNP

Table of content: MARY T. THURLOW-COLLEN CNP (NPI 1215449871)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215449871 NPI number — MARY T. THURLOW-COLLEN CNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
THURLOW-COLLEN
Provider First Name:
MARY
Provider Middle Name:
T.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CNP
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:
1215449871
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/03/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
DENISON UNIVERSITY HEALTH AND COUNSELING CENTER
Provider Second Line Business Mailing Address:
WHISLER HALL, 800 EAST LOOP
Provider Business Mailing Address City Name:
GRANVILLE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43023
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
740-587-6200
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
329 E COLLEGE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GRANVILLE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43023-1317
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-404-9867
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/03/2017

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: 363LA2200X , with the licence number:  RN.231987 , 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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