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General NPI Number Information
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NPI Number | 1902256175
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Entity Type | Organization
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Legal Business Name | JODI JANKOWSKI LISW-S, LLC
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Dates
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Enumeration Date | 06/17/2016
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Last Update Date | 06/17/2016
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Provider Practice Location Address
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Address Line | 520 BROADWAY ST
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City | TOLEDO
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State | OH
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Zip | 43604-8808
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Country | US
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Telephone | 419-349-6584
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Fax |
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Provider Business Mailing Address
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Address Line | 520 BROADWAY ST
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City | TOLEDO
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State | OH
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Zip | 43604-8808
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Country | US
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Telephone | 419-349-6584
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Fax |
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Authorized Official
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Title or Position | CLINICAL THERAPIST/MEMBER
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Name | MS. JODI LYNN JANKOWSKI
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Credential | LISW-S
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Telephone | 419-349-6584
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | I1100168
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License Number State | OH
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