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NPI Code Detail

MEDICARE: MS. BARBARA DOUGLAS LISW

MEDICARE:  MS. BARBARA  DOUGLAS  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
11041C0700XClinical Social WorkerI 0005248OH

General Provider Information

NPI Number : 1780772723
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. BARBARA DOUGLAS LISW
Provider Business Mailing Address
First Line : 1430 S HIGH ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43207-1045
Country : US
Telephone Number : 614-444-4916
Fax Number : 614-444-5839
Provider Business Practice Location Address
First Line : 1430 S HIGH ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43207-1045
Country : US
Telephone Number : 614-444-4916
Fax Number : 614-444-5839
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2006
Last Update Date : 07/08/2007

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Directions to “ MS. BARBARA DOUGLAS LISW” Practice Location

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