Provider Demographics
NPI:1891767646
Name:LOESCH, LINDA JANKOWSKI (MSW LISW ACSW)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:JANKOWSKI
Last Name:LOESCH
Suffix:
Gender:F
Credentials:MSW LISW ACSW
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:MARIE
Other - Last Name:JANKOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW LISW ACSW
Mailing Address - Street 1:2639 UPTON AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606
Mailing Address - Country:US
Mailing Address - Phone:419-471-1848
Mailing Address - Fax:419-471-0037
Practice Address - Street 1:2639 UPTON AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606
Practice Address - Country:US
Practice Address - Phone:419-471-1848
Practice Address - Fax:419-471-0037
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI0001249104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
LOSW29361Medicare ID - Type Unspecified