Provider Information for 1881973360
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Mr. THEODORE FANEUFF MSW,LISW-S, MBA
Other Names:Professional Name:Mr. THEODORE FANEUFF MSW,LISW-S,MBASex: Male
NPI: 1881973360
Last Updated: 2016-07-26
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1881973360 | ||||||||||||
| Enumeration Date | 2011-08-15 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 3335 MEIJER DR STE 450 TOLEDO, OH 43617-3122 United States Phone: 419-324-0334 | Fax: | ||||||||||||
| Primary Practice Address | 3335 MEIJER DR STE 450 TOLEDO, OH 43617-3122 United States Phone: 419-324-0334 | Fax: | ||||||||||||
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