Healthcare Provider Details

I. General information

NPI: 1982294054
Provider Name (Legal Business Name): TRUE SELF LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2021
Last Update Date: 07/29/2024
Certification Date: 07/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3615 BRIARFIELD BLVD
MAUMEE OH
43537-9381
US

IV. Provider business mailing address

1259 CAMBRIDGE BLVD
BOWLING GREEN OH
43402-2669
US

V. Phone/Fax

Practice location:
  • Phone: 419-378-4072
  • Fax: 419-406-4044
Mailing address:
  • Phone: 419-236-8071
  • Fax: 419-406-4044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MARIE ZANFARDINO
Title or Position: OWNER
Credential: LPCC-S
Phone: 419-378-4072