Provider Demographics
NPI:1851805063
Name:ELSWICK, NORA L
Entity Type:Individual
Prefix:
First Name:NORA
Middle Name:L
Last Name:ELSWICK
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 1:505 N CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:DEFIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:43512-1606
Mailing Address - Country:US
Mailing Address - Phone:419-438-3720
Mailing Address - Fax:
Practice Address - Street 1:511 PERRY ST
Practice Address - Street 2:
Practice Address - City:DEFIANCE
Practice Address - State:OH
Practice Address - Zip Code:43512-2123
Practice Address - Country:US
Practice Address - Phone:419-428-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-27
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHS.1303369OtherLICENSE