Healthcare Provider Details

I. General information

NPI: 1417610197
Provider Name (Legal Business Name): SAVANNAH L NAUGLE-BAKER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2021
Last Update Date: 10/19/2021
Certification Date: 10/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2460 CHERRY ST
TOLEDO OH
43608-2667
US

IV. Provider business mailing address

2460 CHERRY ST
TOLEDO OH
43608-2667
US

V. Phone/Fax

Practice location:
  • Phone: 419-244-3053
  • Fax: 419-244-1100
Mailing address:
  • Phone: 419-244-3053
  • Fax: 419-244-1100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.2103759
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: