Provider Demographics
NPI:1629670039
Name:ROWLAND, ABENA
Entity Type:Individual
Prefix:
First Name:ABENA
Middle Name:
Last Name:ROWLAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5726 SOUTHWYCK BLVD STE 200-B
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-1559
Mailing Address - Country:US
Mailing Address - Phone:419-214-1766
Mailing Address - Fax:419-214-1792
Practice Address - Street 1:5726 SOUTHWYCK BLVD STE 200-B
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-1559
Practice Address - Country:US
Practice Address - Phone:419-214-1766
Practice Address - Fax:419-214-1792
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-10
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH01-8165251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health