Healthcare Provider Details

I. General information

NPI: 1356954234
Provider Name (Legal Business Name): HEDWIG HUEBLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2020
Last Update Date: 08/28/2020
Certification Date: 08/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2556 PALMER LN
AVON OH
44011-2044
US

IV. Provider business mailing address

2556 PALMER LN
AVON OH
44011-2044
US

V. Phone/Fax

Practice location:
  • Phone: 440-716-9100
  • Fax:
Mailing address:
  • Phone: 440-731-0115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: