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General NPI Number Information
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NPI Number | 1518588441
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Entity Type | Organization
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Legal Business Name | GLORIA M ESQUIVEL-LYNCH LLC
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Dates
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Enumeration Date | 05/01/2020
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Last Update Date | 05/30/2021
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Provider Practice Location Address
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Address Line | 404 HAMILTON RD STE 4
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City | WAPAKONETA
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State | OH
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Zip | 45895-1156
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Country | US
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Telephone | 419-739-7002
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 62
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City | WAPAKONETA
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State | OH
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Zip | 45895-0062
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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 | OWNER/CLINICAL SOCIAL WORKER
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Name | GLORIA MARIE ESQUIVEL-LYNCH
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Credential | LISW-S
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Telephone | 419-739-7002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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