Provider Demographics
NPI:1942624127
Name:DOWNER, MARY (LISW)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:DOWNER
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 STONEMILL RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45409-2526
Mailing Address - Country:US
Mailing Address - Phone:937-285-5294
Mailing Address - Fax:
Practice Address - Street 1:8668 MIAMISBURG SPRINGBORO RD
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-3493
Practice Address - Country:US
Practice Address - Phone:937-865-0011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-10
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI09002271041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool