Healthcare Provider Details

I. General information

NPI: 1689112401
Provider Name (Legal Business Name): CHRISTINA R ROVAH LISW-S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHRISTINA R THORPE LISW-S

II. Dates (important events)

Enumeration Date: 02/01/2017
Last Update Date: 03/14/2022
Certification Date: 03/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7628 SLATE RIDGE BLVD
REYNOLDSBURG OH
43068-8159
US

IV. Provider business mailing address

7628 SLATE RIDGE BLVD
REYNOLDSBURG OH
43068-8159
US

V. Phone/Fax

Practice location:
  • Phone: 614-537-7073
  • Fax: 614-705-6539
Mailing address:
  • Phone: 614-537-7073
  • Fax: 614-705-6539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.450548
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: