Organization
OHIO ARMY NATIONAL GUARD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID ISAAC KIRKER LISW (CLINICAL THERAPIST/SOCIAL WORKER)
(614) 336-7393
Entity
Organization
Contact information
Practice address
3990 E BROAD ST, DSCC, BUILDING 11, SEC.11, COLUMBUS, OH 43213-1152
(614) 336-7393
Mailing address
3990 E BROAD ST, DSCC, BUILDING 11, SEC.11, COLUMBUS, OH 43213-1152
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
0900648
OH
251S00000X
Community/Behavioral Health Agency
Primary
0922648
OH
Other
Enumeration date
05/06/2014
Last updated
05/06/2014
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