Individual
GRACE LUANGISA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
899 E BROAD ST, 3RD FLOOR, COLUMBUS, OH 43205-1156
(614) 355-8000
(614) 355-8018
Mailing address
899 E BROAD ST, 3RD FLOOR, COLUMBUS, OH 43205-1156
(614) 355-8000
(614) 355-8018
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
S0801043
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08258
—
OH
Enumeration date
05/01/2010
Last updated
05/01/2010
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