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NPI Code Detail

MEDICARE: MR. JASON L AVINA PC

MEDICARE: MR. JASON L AVINA PC
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
1101YM0800XMental Health CounselorC0601074OH

General Provider Information

NPI Number : 1366614521
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JASON L AVINA PC
Provider Business Mailing Address
First Line : 123 22ND ST
Second Line :
City : TOLEDO
State : OH
Zip : 43604-2706
Country : US
Telephone Number : 419-241-6191
Fax Number :
Provider Business Practice Location Address
First Line : 123 22ND ST
Second Line :
City : TOLEDO
State : OH
Zip : 43604-2706
Country : US
Telephone Number : 419-241-6191
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2008
Last Update Date : 03/27/2008

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Directions to “ MR. JASON L AVINA PC” Practice Location

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