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General NPI Number Information
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NPI Number | 1700495397
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Entity Type | Individual
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Provider Name | HANNAH ELIZABETH ANDRUS LISW
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Gender | Female
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Dates
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Enumeration Date | 07/29/2020
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Last Update Date | 08/15/2023
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Provider Practice Location Address
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Address Line | 4159 N HOLLAND SYLVANIA RD STE 205
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City | TOLEDO
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State | OH
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Zip | 43623-4801
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Country | US
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Telephone | 419-318-5286
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Fax |
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Provider Business Mailing Address
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Address Line | 2624 BEAUFORT AVE
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City | TOLEDO
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State | OH
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Zip | 43613-4804
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Country | US
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Telephone | 419-206-2357
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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 | S.2004905
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I.2304611
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License Number State | OH
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