Healthcare Provider Details

I. General information

NPI: 1508425299
Provider Name (Legal Business Name): KRISTINA LOUISE VAHOSKI MSW, LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2019
Last Update Date: 04/09/2021
Certification Date: 04/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2005 ASHLAND AVE
TOLEDO OH
43620
US

IV. Provider business mailing address

PO BOX 823
PERRYSBURG OH
43552-0823
US

V. Phone/Fax

Practice location:
  • Phone: 419-841-7701
  • Fax:
Mailing address:
  • Phone: 419-491-0420
  • Fax: 567-698-7875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.1802746
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: