Provider Demographics
NPI:1740584630
Name:TIMMS, STEVEN M (PC)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:M
Last Name:TIMMS
Suffix:
Gender:M
Credentials:PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 22ND ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-2706
Mailing Address - Country:US
Mailing Address - Phone:419-241-6191
Mailing Address - Fax:419-255-5623
Practice Address - Street 1:4334 SECOR RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-4234
Practice Address - Country:US
Practice Address - Phone:419-475-4449
Practice Address - Fax:419-479-3833
Is Sole Proprietor?:No
Enumeration Date:2011-01-06
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.0900124101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional