Healthcare Provider Details

I. General information

NPI: 1568682664
Provider Name (Legal Business Name): DORIS H TOLAND ACSW LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 W BROAD ST SOCIAL WORK DEPT KOSAR BLDG ATTN SOCIAL WORK DIRECTOR
COLUMBUS OH
43223-1297
US

IV. Provider business mailing address

2200 W BROAD ST SOCIAL WORK DEPT KOSAR BLDG ATTN SOCIAL WORK DIRECTOR
COLUMBUS OH
43223-1297
US

V. Phone/Fax

Practice location:
  • Phone: 614-752-0333
  • Fax: 614-752-0385
Mailing address:
  • Phone: 614-752-0333
  • Fax: 614-752-0385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberI0004429
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: