Organization
ANGELA BOMMARITO LISW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA ROSE BOMMARITO MSW LISW-S (PSYCHOTHERAPIST)
(614) 270-0910
Entity
Organization
Contact information
Practice address
167 S STATE ST STE 120, WESTERVILLE, OH 43081-2278
(614) 270-0910
Mailing address
PO BOX 902, ATHENS, OH 45701-0902
(614) 270-0910
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-0700030 SUPV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1497880900
INDIVIDUAL TYPE 1 NPI
—
Enumeration date
03/23/2010
Last updated
03/23/2010
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