Healthcare Provider Details

I. General information

NPI: 1497873566
Provider Name (Legal Business Name): SEASON'S PEDIATRIC WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 FRANKLIN ST
TORONTO OH
43964-1155
US

IV. Provider business mailing address

1101 FRANKLIN ST
TORONTO OH
43964-1155
US

V. Phone/Fax

Practice location:
  • Phone: 740-424-0132
  • Fax: 740-282-0863
Mailing address:
  • Phone: 740-424-0132
  • Fax: 740-282-0863

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. ANNJANETTE DUNBAR
Title or Position: EXECUTIVE DIRECTOR
Credential: B.A.
Phone: 740-424-0132