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NPI Code Detail

MEDICARE: MRS. ANNE VERONICA CRUTCHMAN LISW

MEDICARE: MRS. ANNE VERONICA CRUTCHMAN 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 WorkerS0031804OH
21041C0700XClinical Social WorkerI0800273-SUPVOH

General Provider Information

NPI Number : 1700090206
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ANNE VERONICA CRUTCHMAN LISW
Provider Business Mailing Address
First Line : 1856 CEDAR HILL ROAD
Second Line :
City : LANCASTER
State : OH
Zip : 43130-4178
Country : US
Telephone Number : 740-687-4500
Fax Number : 740-687-4595
Provider Business Practice Location Address
First Line : 1856 CEDAR HILL ROAD
Second Line :
City : LANCASTER
State : OH
Zip : 43130-4178
Country : US
Telephone Number : 740-687-4500
Fax Number : 740-687-4595
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2007
Last Update Date : 07/06/2011

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