Provider Demographics
NPI:1134204712
Name:CRONIN, TANIA E (LISW)
Entity type:Individual
Prefix:
First Name:TANIA
Middle Name:E
Last Name:CRONIN
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 1:4762 WENATCHIE TRL
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45805-4107
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1301 BELLEFONTAINE AVE
Practice Address - Street 2:SUITE A
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804-3121
Practice Address - Country:US
Practice Address - Phone:419-222-4852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI. 00073711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical