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NPI Code Detail

MEDICARE: MARK A SPIELES LISW

MEDICARE:   MARK A SPIELES  LISW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerI0700426OH

General Provider Information

NPI Number : 1003099292
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK A SPIELES LISW
Provider Business Mailing Address
First Line : 603 S WASHINGTON ST
Second Line :
City : VAN WERT
State : OH
Zip : 45891-2307
Country : US
Telephone Number : 419-302-9210
Fax Number :
Provider Business Practice Location Address
First Line : 1158 WESTWOOD DR
Second Line :
City : VAN WERT
State : OH
Zip : 45891-2449
Country : US
Telephone Number : 419-238-3434
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2007
Last Update Date : 12/11/2007

Similar Medicare Providers

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1467616466 — ANTHONY W. GREUTMAN LSW, LICDC
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Directions to “ MARK A SPIELES LISW” Practice Location

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