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General NPI Number Information
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NPI Number | 1366049090
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Entity Type | Individual
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Provider Name | DANA BOBALIK LSW
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Gender | Female
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Dates
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Enumeration Date | 10/06/2020
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 1101 N VANDEMARK RD
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City | SIDNEY
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State | OH
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Zip | 45365-3567
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Country | US
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Telephone | 937-622-7393
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Fax |
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Provider Business Mailing Address
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Address Line | 11191 NEW CARLISLE PIKE
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City | NEW CARLISLE
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State | OH
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Zip | 45344-8512
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Country | US
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Telephone | 937-304-8956
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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 | S.0800829
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License Number State | OH
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