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NPI Code Detail

MEDICARE: MS. JANNA LE TENHUISEN LISW, MSSA

MEDICARE: MS. JANNA LE TENHUISEN LISW, MSSA
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 WorkerI0008661OH

General Provider Information

NPI Number : 1447351788
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JANNA LE TENHUISEN LISW, MSSA
Provider Business Mailing Address
First Line : 340 S BROADWAY ST
Second Line :
City : AKRON
State : OH
Zip : 44308-1529
Country : US
Telephone Number : 330-253-3100
Fax Number : 330-253-5248
Provider Business Practice Location Address
First Line : 340 S BROADWAY ST
Second Line :
City : AKRON
State : OH
Zip : 44308-1529
Country : US
Telephone Number : 330-253-3100
Fax Number : 330-253-5248
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2006
Last Update Date : 07/08/2007

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