Provider Information for 1063810596
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MAXIMILLION M LENCL LPCC
Sex: Male
NPI: 1063810596
Last Updated: 2014-12-16
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1063810596 | ||||||||
| Enumeration Date | 2014-12-16 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 6797 N HIGH ST SUITE 244 WORTHINGTON, OH 43085-2533 United States Phone: 614-505-7561 | Fax:614-505-7562 | ||||||||
| Primary Practice Address | 6797 N HIGH ST SUITE 244 WORTHINGTON, OH 43085-2533 United States Phone: 614-505-7561 | Fax:614-505-7562 | ||||||||
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