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Organization
WATER BLUE THERAPY
Active
Organization
WATER BLUE THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KELLIE RENEE COUSINO LISA (CEO)
(419) 217-2122
Entity
Organization
Contact information
Practice address
3443 146TH ST, TOLEDO, OH 43611-2513
(419) 217-2122
Mailing address
3443 146TH ST, TOLEDO, OH 43611-2513
(419) 217-2122
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
07/06/2022
Last updated
07/06/2022
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