Healthcare Provider Details

I. General information

NPI: 1316181704
Provider Name (Legal Business Name): TARIN L MINK LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2009
Last Update Date: 05/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3086 SR 160
GALLIPOLIS OH
45631-8409
US

IV. Provider business mailing address

3086 SR 160
GALLIPOLIS OH
45631-8409
US

V. Phone/Fax

Practice location:
  • Phone: 740-446-5500
  • Fax: 740-441-4402
Mailing address:
  • Phone: 740-446-5500
  • Fax: 740-441-4402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS0030291
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: