Provider Demographics
NPI:1982735353
Name:SZYDLOWSKI, MARY ANN (RN LMFT)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:ANN
Last Name:SZYDLOWSKI
Suffix:
Gender:F
Credentials:RN LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6832 CONVENT BLVD
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560
Mailing Address - Country:US
Mailing Address - Phone:419-882-4529
Mailing Address - Fax:418-885-7612
Practice Address - Street 1:6832 CONVENT BLVD
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560
Practice Address - Country:US
Practice Address - Phone:419-882-4529
Practice Address - Fax:418-885-7612
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH164109163W00000X
OH7169225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH164109OtherRN BOARD OF NURSING EDUCA
OH7169OtherLMT OHIO STATE MEDICAL BO