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NPI Code Detail

MEDICARE: MRS. ALISON MARIE SOBOWALE LISW

MEDICARE: MRS. ALISON MARIE SOBOWALE LISW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerI.1500126-SUPVOH
21041C0700XClinical Social WorkerL.1500126OH

General Provider Information

NPI Number : 1407217946
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ALISON MARIE SOBOWALE LISW
Provider Business Mailing Address
First Line : 700 ACKERMAN RD STE 2120
Second Line :
City : COLUMBUS
State : OH
Zip : 43202-1559
Country : US
Telephone Number : 614-293-5123
Fax Number : 614-293-4890
Provider Business Practice Location Address
First Line : 895 YARD ST
Second Line :
City : GRANDVIEW
State : OH
Zip : 43212-3886
Country : US
Telephone Number : 614-293-5123
Fax Number : 614-293-4890
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2016
Last Update Date : 07/23/2024

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