Provider Demographics
NPI:1447888086
Name:TOBUL, DONALD J
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:J
Last Name:TOBUL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6311 CHERYL PL
Mailing Address - Street 2:
Mailing Address - City:PAINESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44077-2410
Mailing Address - Country:US
Mailing Address - Phone:440-251-0890
Mailing Address - Fax:
Practice Address - Street 1:35595 CURTIS BLVD UNIT J
Practice Address - Street 2:
Practice Address - City:EASTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44095-4100
Practice Address - Country:US
Practice Address - Phone:440-251-0890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-30
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1200335101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health