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Organization

CRUCIBLE LIFE RESOURCES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
WILLIAM K ROMAN LMSW (LMSW)
(419) 344-3671
Entity
Organization

Contact information

Practice address
3130 EXECUTIVE PKWY, SUITE 908, TOLEDO, OH 43606-5529
(419) 344-3671
Mailing address
3408 CHRISTIE BLVD, TOLEDO, OH 43606-2863
(419) 344-3671

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C1100264
OH

Other

Enumeration date
05/14/2013
Last updated
05/14/2013
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