Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | S.1701561 | OH |
NPI | 1003452350 |
---|---|
Provider Name | Tess J Lohse |
First Address | Defiance, OH 43512-9674 |
Second Address | Bowling Green, OH 43402-4820 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2019 |
Last Update Date | 21/11/2019 |