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NPI Code Detail

MEDICARE: FRESCIA ERICA POTH MSW, LISW

MEDICARE:   FRESCIA ERICA POTH  MSW, LISW
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
11041C0700XClinical Social WorkerI 1303358OH

General Provider Information

NPI Number : 1447697008
Entity Type Code : Individual
Provider Name (Legal Business Name) : FRESCIA ERICA POTH MSW, LISW
Provider Business Mailing Address
First Line : 1066 LEXINGTON AVE
Second Line :
City : MANSFIELD
State : OH
Zip : 44907-2250
Country : US
Telephone Number : 419-526-5523
Fax Number :
Provider Business Practice Location Address
First Line : 1066 LEXINGTON AVE
Second Line :
City : MANSFIELD
State : OH
Zip : 44907-2250
Country : US
Telephone Number : 419-526-5523
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2013
Last Update Date : 10/27/2013

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Directions to “ FRESCIA ERICA POTH MSW, LISW” Practice Location

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