Healthcare Provider Details

I. General information

NPI: 1629298302
Provider Name (Legal Business Name): HOLLY H LALONDE MSW, LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1560 FISHINGER RD
COLUMBUS OH
43221-2108
US

IV. Provider business mailing address

2190 VICTORIA PARK DR
COLUMBUS OH
43235-7131
US

V. Phone/Fax

Practice location:
  • Phone: 614-457-7876
  • Fax: 614-457-7896
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI0008267
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: