1225268956 NPI number — PAMELA HINES-DUNN LISW-S, LCDCIII

Table of content: PAMELA HINES-DUNN LISW-S, LCDCIII (NPI 1225268956)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225268956 NPI number — PAMELA HINES-DUNN LISW-S, LCDCIII

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HINES-DUNN
Provider First Name:
PAMELA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LISW-S, LCDCIII
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:
1225268956
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/15/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1283 CONANT ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MAUMEE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43537-1607
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-482-6032
Provider Business Mailing Address Fax Number:
419-482-6740

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1283 CONANT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MAUMEE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43537-1607
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-482-6032
Provider Business Practice Location Address Fax Number:
419-482-6740
Provider Enumeration Date:
07/15/2009

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: 101YA0400X , with the licence number:  991801 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: I9871-SUPV , 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)





Copyright © 2007-2025 www.npivalidator.com