Provider Demographics
NPI:1770272122
Name:SOHN, PAULINE
Entity type:Individual
Prefix:
First Name:PAULINE
Middle Name:
Last Name:SOHN
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 1:3535 FISHINGER BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-2000
Mailing Address - Country:US
Mailing Address - Phone:380-234-6534
Mailing Address - Fax:
Practice Address - Street 1:3535 FISHINGER BLVD STE 110
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-2000
Practice Address - Country:US
Practice Address - Phone:614-819-3137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-02
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2300719-TEMP104100000X
OHS.2309071104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker