Healthcare Provider Details

I. General information

NPI: 1477246510
Provider Name (Legal Business Name): CORINNE BOYER QMHS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2023
Last Update Date: 08/16/2023
Certification Date: 08/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3086 SR 160
GALLIPOLIS OH
45631-8409
US

IV. Provider business mailing address

PO BOX 188
CHILLICOTHEE OH
45601-0188
US

V. Phone/Fax

Practice location:
  • Phone: 740-446-5500
  • Fax:
Mailing address:
  • Phone: 740-773-4366
  • Fax: 740-773-4426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2309733
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: