Healthcare Provider Details

I. General information

NPI: 1396654570
Provider Name (Legal Business Name): CHRISTINE CLOSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

938 S KIBLER ST
NEW WASHINGTON OH
44854-9521
US

IV. Provider business mailing address

938 S KIBLER ST
NEW WASHINGTON OH
44854-9521
US

V. Phone/Fax

Practice location:
  • Phone: 419-492-1021
  • Fax: 419-492-2039
Mailing address:
  • Phone: 419-492-1021
  • Fax: 419-492-2039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number22466661
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: