Healthcare Provider Details

I. General information

NPI: 1679381933
Provider Name (Legal Business Name): ISABELLA GRACE KLAUSING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2024
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4761 STATE ROUTE 29
CELINA OH
45822-8216
US

IV. Provider business mailing address

4761 STATE ROUTE 29
CELINA OH
45822-8216
US

V. Phone/Fax

Practice location:
  • Phone: 419-584-1000
  • Fax: 419-584-1825
Mailing address:
  • Phone: 419-584-1000
  • Fax: 419-584-1825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-23-257023
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: