Healthcare Provider Details

I. General information

NPI: 1497256390
Provider Name (Legal Business Name): MARGARET M LAWRENCE CDCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2018
Last Update Date: 02/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

799 S MAIN ST
LIMA OH
45804-1519
US

IV. Provider business mailing address

799 S MAIN ST
LIMA OH
45804-1519
US

V. Phone/Fax

Practice location:
  • Phone: 567-242-6034
  • Fax: 419-229-2227
Mailing address:
  • Phone: 567-242-6034
  • Fax: 419-229-2227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCA.164003
License Number StateOH

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: