Provider Demographics
NPI:1548953615
Name:TOMASZEWSKI, SAMANTHA ARIN (EDS)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:ARIN
Last Name:TOMASZEWSKI
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:ARIN
Other - Last Name:OSTACHNOWICZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:EDS
Mailing Address - Street 1:3900 SUNFOREST CT STE 215
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-4440
Mailing Address - Country:US
Mailing Address - Phone:419-473-6670
Mailing Address - Fax:419-473-9959
Practice Address - Street 1:3900 SUNFOREST CT STE 215
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-4440
Practice Address - Country:US
Practice Address - Phone:419-473-6670
Practice Address - Fax:419-473-9959
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MISP0000001108205103TS0200X
OHOH3225693103TS0200X
OHSP.00713103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool