Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003314758 |
---|---|
Provider Name | Timothy Alan Loew |
First Address | Grove City, OH 43123-4888 |
Second Address | Grove City, OH 43123-9122 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2018 |
Last Update Date | 29/01/2018 |