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NPI Code Detail

MEDICARE: REX DELL LPCC

MEDICARE: REX DELL LPCC
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
1104100000XSocial WorkerE-0001990OH

General Provider Information

NPI Number : 1265547558
Entity Type Code : Individual
Provider Name (Legal Business Name) : REX DELL LPCC
Provider Business Mailing Address
First Line : 916 N MARKET ST
Second Line :
City : LISBON
State : OH
Zip : 44432-1024
Country : US
Telephone Number : 330-424-9573
Fax Number :
Provider Business Practice Location Address
First Line : 40722 STATE ROUTE 154
Second Line :
City : LISBON
State : OH
Zip : 44432-8500
Country : US
Telephone Number : 330-424-9573
Fax Number : 330-424-0877
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2006
Last Update Date : 07/08/2007

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Directions to “ REX DELL LPCC” Practice Location

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