Provider Demographics
NPI:1598968240
Name:KIEHN, LAURA (SWA, TO)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:KIEHN
Suffix:
Gender:F
Credentials:SWA, TO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:464 E WARD ST
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:OH
Mailing Address - Zip Code:43078-1774
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1150 SCIOTO ST STE 200
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:OH
Practice Address - Zip Code:43078-2291
Practice Address - Country:US
Practice Address - Phone:937-684-1769
Practice Address - Fax:937-652-4945
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker