Individual
ANGEL LUIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 E MAIN ST, COLUMBUS, OH 43215-5369
(614) 355-6342
Mailing address
DEPT 781625, DETROIT, MI 48278-1625
(614) 355-8004
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
S.2106120
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1473276
—
OH
Enumeration date
05/27/2021
Last updated
06/29/2021
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