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General NPI Number Information
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NPI Number | 1942786009
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Entity Type | Individual
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Provider Name | INDIA CRAFT LCDC III
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Gender | Female
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Dates
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Enumeration Date | 07/12/2018
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 544 E WOODRUFF AVE
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City | TOLEDO
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State | OH
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Zip | 43604-5342
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Country | US
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Telephone | 419-936-7548
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Fax |
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Provider Business Mailing Address
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Address Line | 7220 NIGHTINGALE DR APT 11
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City | HOLLAND
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State | OH
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Zip | 43528-9302
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Country | US
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Telephone | 419-322-6864
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 162905
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License Number State | OH
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