Provider Demographics
NPI:1326415605
Name:ONTKO, ALLISON D (LISW-S)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:D
Last Name:ONTKO
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 BERLIN RD
Mailing Address - Street 2:
Mailing Address - City:HURON
Mailing Address - State:OH
Mailing Address - Zip Code:44839-1909
Mailing Address - Country:US
Mailing Address - Phone:419-602-7141
Mailing Address - Fax:
Practice Address - Street 1:1031 PIERCE ST STE 306
Practice Address - Street 2:
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-4669
Practice Address - Country:US
Practice Address - Phone:419-602-7141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-21
Last Update Date:2023-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.17006471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical