Healthcare Provider Details

I. General information

NPI: 1164327243
Provider Name (Legal Business Name): TRAVESTEEN NM LAWSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28555 STARBRIGHT BLVD
PERRYSBURG OH
43551-5662
US

IV. Provider business mailing address

28555 STARBRIGHT BLVD
PERRYSBURG OH
43551-5662
US

V. Phone/Fax

Practice location:
  • Phone: 418-354-5224
  • Fax:
Mailing address:
  • Phone: 419-345-5224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: