Healthcare Provider Details

I. General information

NPI: 1689765836
Provider Name (Legal Business Name): GEORGE RALPH LAWSON MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60209 E GREYSTONE DR
TUCSON AZ
85739-1962
US

IV. Provider business mailing address

CMR 454 BOX 1516 APO AE 09250
ANSPACH BAVARIA
09250
DE

V. Phone/Fax

Practice location:
  • Phone: 520-818-3211
  • Fax:
Mailing address:
  • Phone: 09802832850
  • Fax: 09802832205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-3505
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: