Healthcare Provider Details

I. General information

NPI: 1992898829
Provider Name (Legal Business Name): RESOURCES FOR HEALTHY LIVING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 LOUSIANA AVENUE SUITE A
PERRYSBURG OH
43551
US

IV. Provider business mailing address

330 LOUSIANA AVENUE SUITE A
PERRYSBURG OH
43551
US

V. Phone/Fax

Practice location:
  • Phone: 419-874-9488
  • Fax: 419-874-4822
Mailing address:
  • Phone: 419-874-9488
  • Fax: 419-874-4822

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number5761
License Number StateOH

VIII. Authorized Official

Name: MARCIA WARD
Title or Position: MARCIA WARD PHD
Credential: PHD
Phone: 419-874-9488