Provider Demographics
NPI:1316688484
Name:KLOSHEN, BLYTHE FRANCESCA LISETTE
Entity type:Individual
Prefix:
First Name:BLYTHE
Middle Name:FRANCESCA LISETTE
Last Name:KLOSHEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BLYTHE
Other - Middle Name:FRANCESCA LISETTE
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1046 FRANCIS AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43609-1916
Mailing Address - Country:US
Mailing Address - Phone:419-654-1001
Mailing Address - Fax:
Practice Address - Street 1:530 REGINA PKWY
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43612-3326
Practice Address - Country:US
Practice Address - Phone:419-290-1495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator