Provider Demographics
NPI:1205852563
Name:DEPP, LOIS ANN (MSW, ACSW)
Entity Type:Individual
Prefix:MRS
First Name:LOIS
Middle Name:ANN
Last Name:DEPP
Suffix:
Gender:F
Credentials:MSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1169 TIMBER HAWK TRL
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45458-9636
Mailing Address - Country:US
Mailing Address - Phone:937-267-3909
Mailing Address - Fax:937-267-5314
Practice Address - Street 1:1169 TIMBER HAWK TRL
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45458-9636
Practice Address - Country:US
Practice Address - Phone:937-267-3909
Practice Address - Fax:937-267-5314
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-00025591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical