Individual
SUMMER POLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
511 PERRY ST, DEFIANCE, OH 43512-2123
(419) 782-9920
(419) 784-2523
Mailing address
321 KAUFMAN ST, HOLGATE, OH 43527-9566
(419) 619-8802
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LSW
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LSW
COUNSELOR, SOCIAL WORKER, & MFT BOARD
OH
Enumeration date
09/08/2020
Last updated
09/08/2020
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