MEDICARE: RACHEL MARIE HARTMAN

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.2405940	OH

General Provider Information

NPI Number	:	1144735796
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL MARIE HARTMAN

Provider Business Mailing Address
First Line	:	2005 ASHLAND AVE
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43620-1703
Country	:	US
Telephone Number	:	419-841-7701
Fax Number	:

Provider Business Practice Location Address
First Line	:	715 S COY RD
Second Line	:
City	:	OREGON
State	:	OH
Zip	:	43616-3010
Country	:	US
Telephone Number	:	419-720-5800
Fax Number	:

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

Provider Enumeration Date	:	12/05/2017
Last Update Date	:	11/13/2024

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