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General NPI Number Information
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NPI Number | 1780806364
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Entity Type | Individual
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Provider Name | KRISTINE LOUISE BUFFINGTON LISW
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Gender | Female
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7140 PORT SYLVANIA DR #600
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City | TOLEDO
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State | OH
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Zip | 43617-1176
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Country | US
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Telephone | 419-843-8178
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Fax | 419-843-8698
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Provider Business Mailing Address
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Address Line | 2150 W CENTRAL AVE 2ND FLOOR
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City | TOLEDO
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State | OH
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Zip | 43606-3846
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Country | US
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Telephone | 419-291-7919
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Fax | 419-479-3273
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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 | 0004823
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License Number State | OH
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