Organization
DIANA L THEISS PHD
Active
Other names
Sylvania Therapy and Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA L THEISS PHD LISW (PRACTICE OWNER)
(419) 843-5945
Entity
Organization
Contact information
Practice address
5800 MONROE ST STE A1, SYLVANIA, OH 43560-2208
(419) 517-7073
(419) 517-0122
Mailing address
5800 MONROE ST STE A1, SYLVANIA, OH 43560-2208
(419) 517-7073
(419) 517-0122
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I0900183-SUPV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0155198
—
OH
Enumeration date
12/13/2017
Last updated
03/02/2023
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