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General NPI Number Information
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NPI Number | 1487181616
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Entity Type | Individual
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Provider Name | LIAT JOHNSON LISW-S
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Gender | Female
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Dates
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Enumeration Date | 05/18/2017
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Last Update Date | 03/29/2019
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Provider Practice Location Address
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Address Line | 2525 TILLER LN
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City | COLUMBUS
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State | OH
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Zip | 43231-2267
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Country | US
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Telephone | 614-783-1091
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Fax |
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Provider Business Mailing Address
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Address Line | 1655 TWIN OAKS DR
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City | POWELL
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State | OH
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Zip | 43065-9511
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | I0010240
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License Number State | OH
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