Healthcare Provider Details

I. General information

NPI: 1952807745
Provider Name (Legal Business Name): JOAN PARKER QMHS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2018
Last Update Date: 04/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5164 MONROE ST
TOLEDO OH
43623-3471
US

IV. Provider business mailing address

885 COMMERCE DR
PERRYSBURG OH
43551-5267
US

V. Phone/Fax

Practice location:
  • Phone: 419-720-9586
  • Fax:
Mailing address:
  • Phone: 419-330-5122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: