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General NPI Number Information
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NPI Number | 1295546059
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Entity Type | Individual
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Provider Name | MICHELLE WAHL MEEHAN LISW-S
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Gender | Female
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Dates
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Enumeration Date | 01/20/2025
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Last Update Date | 01/20/2025
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Provider Practice Location Address
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Address Line | 1620 BRIGHAM DR STE 240
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City | PERRYSBURG
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State | OH
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Zip | 43551-7124
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Country | US
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Telephone | 419-872-7700
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Fax | 419-874-0196
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Provider Business Mailing Address
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Address Line | 3247 MAETERLINCK AVE
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City | TOLEDO
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State | OH
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Zip | 43614-3841
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Country | US
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Telephone | 419-261-2732
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | I.16000325
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License Number State | OH
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