Healthcare Provider Details

I. General information

NPI: 1114214244
Provider Name (Legal Business Name): ELIZABETH A ESCH LISW-CP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2011
Last Update Date: 07/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 CROWN POINTE PKWY SUITE 450
ATLANTA GA
30338-7707
US

IV. Provider business mailing address

897 FORDING ISLAND RD # 1604
BLUFFTON SC
29910-4846
US

V. Phone/Fax

Practice location:
  • Phone: 866-325-5434
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number9412
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: