Most Relevant Information
Provider Data
| NPI Number: | 1003350448 |
| Provider Name: | ETHAN THOMAS CRAIG |
| Entity Type: | Individual |
| Taxonomy Code: | 104100000X |
| Specialty: | Social Worker |
| License Number: | S.1903694 |
Most Important Dates
| Enumeration Date: | 12/04/2016 |
| Last Updated: | 05/31/2019 |
Provider Practice Location
1199 DELAWARE AVE STE 107
195 N GRANT AVE, COLUMBUS, OH 43215
MARION
OH
43302
Practice Location Phone/Fax
| Phone: | 8885229174 |
| Fax: |
Provider Mailing Location
1865 BEALER DR APT G
MARION
OH
433028764
Provider Mailing Phone/Fax
| Phone: | 7403619098 |
| Fax: |