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NPI Code Detail

MEDICARE: AIDA DIALLO LISW

MEDICARE:   AIDA  DIALLO  LISW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker090444NY
21041C0700XClinical Social WorkerI.2304808OH

General Provider Information

NPI Number : 1619533205
Entity Type Code : Individual
Provider Name (Legal Business Name) : AIDA DIALLO LISW
Provider Business Mailing Address
First Line : 5310 E MAIN ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43213-2598
Country : US
Telephone Number : 614-751-1090
Fax Number :
Provider Business Practice Location Address
First Line : 5310 E MAIN ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43213-2598
Country : US
Telephone Number : 614-751-1090
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2019
Last Update Date : 12/15/2025

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Directions to “ AIDA DIALLO LISW” Practice Location

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