Individual
GARY J INCORVAIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LISW-S
Contact information
Practice address
5800 MONROE ST, BLDG B, STE 3, SYLVANIA, OH 43560-2263
(419) 727-1200
(419) 727-1200
Mailing address
5800 MONROE ST, BLDG B, STE 3, SYLVANIA, OH 43560-2263
(419) 727-1200
(419) 727-1200
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
6801088367
MI
1041C0700X
Clinical Social Worker
Primary
I-007136
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
-0162066
—
OH
01
—
11586146
CAQH
—
Enumeration date
01/05/2007
Last updated
05/06/2024
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