Provider Demographics
NPI:1760529689
Name:LOESSER, MICHELE ANN (PCC)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:ANN
Last Name:LOESSER
Suffix:
Gender:F
Credentials:PCC
Other - Prefix:
Other - First Name:SHELLEY
Other - Middle Name:
Other - Last Name:LOESSER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:711 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:TIFFIN
Mailing Address - State:OH
Mailing Address - Zip Code:44883-3316
Mailing Address - Country:US
Mailing Address - Phone:419-447-8111
Mailing Address - Fax:419-447-8158
Practice Address - Street 1:676 MIAMI ST STE A
Practice Address - Street 2:
Practice Address - City:TIFFIN
Practice Address - State:OH
Practice Address - Zip Code:44883-1903
Practice Address - Country:US
Practice Address - Phone:567-220-6495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE2987101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional