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General NPI Number Information
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NPI Number | 1235607300
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Entity Type | Individual
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Provider Name | ASHLEY NICHOLE THIELMAN LISW
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Gender | Female
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Dates
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Enumeration Date | 11/07/2018
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Last Update Date | 08/12/2024
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Provider Practice Location Address
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Address Line | 5800 MONROE ST STE A9
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City | SYLVANIA
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State | OH
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Zip | 43560-2208
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Country | US
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Telephone | 419-318-3818
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Fax | 877-927-2984
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Provider Business Mailing Address
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Address Line | 25940 W RIVER RD
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City | PERRYSBURG
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State | OH
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Zip | 43551-9786
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Country | US
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Telephone | 419-481-0806
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I.2204158
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License Number State | OH
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