Individual
ALICIA C SUPANCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
2000 POLARIS PKWY, SUITE 100, COLUMBUS, OH 43240-2108
(614) 430-9697
Mailing address
2000 POLARIS PKWY, SUITE 100, COLUMBUS, OH 43240-2108
(614) 430-9697
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
S.0700809
OH
Other
Enumeration date
09/26/2007
Last updated
09/26/2007
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