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NPI Code Detail

MEDICARE: MRS. CHRISTINE R PACK BSW, LSW

MEDICARE: MRS. CHRISTINE R PACK BSW, LSW
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 WorkerS1101026OH

General Provider Information

NPI Number : 1811309917
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CHRISTINE R PACK BSW, LSW
Provider Business Mailing Address
First Line : 658 W MARKET ST STE 101
Second Line :
City : LIMA
State : OH
Zip : 45801-5604
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 658 W MARKET ST STE 101
Second Line :
City : LIMA
State : OH
Zip : 45801-5604
Country : US
Telephone Number : 419-222-1527
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2014
Last Update Date : 05/27/2025

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Directions to “ MRS. CHRISTINE R PACK BSW, LSW” Practice Location

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