MEDICARE: MRS. JOAN M HINKELMAN LISW-S

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	I.0900017	OH

General Provider Information

NPI Number	:	1013264977
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JOAN M HINKELMAN LISW-S

Provider Business Mailing Address
First Line	:	6753 STATE RD
Second Line	:
City	:	PARMA
State	:	OH
Zip	:	44134-4517
Country	:	US
Telephone Number	:	440-843-5622
Fax Number	:	440-843-1626

Provider Business Practice Location Address
First Line	:	6753 STATE RD
Second Line	:
City	:	PARMA
State	:	OH
Zip	:	44134-4517
Country	:	US
Telephone Number	:	440-843-5622
Fax Number	:	440-843-1626

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2012
Last Update Date	:	08/10/2012

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