Healthcare Provider Details

I. General information

NPI: 1366369258
Provider Name (Legal Business Name): NICOLE ANNE HOROSZEWSKI QMHS 3
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 RIVER RD
MAUMEE OH
43537-3637
US

IV. Provider business mailing address

7445 WEMBLEY CT
TEMPERANCE MI
48182-9185
US

V. Phone/Fax

Practice location:
  • Phone: 419-724-2264
  • Fax: 234-200-2834
Mailing address:
  • Phone: 734-347-6146
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: