Most Relevant Information
Provider Data
| NPI Number: | 1003396045 |
| Provider Name: | LISA THOMAS-BLACKWELL CDCA |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/20/2018 |
| Last Updated: | 08/20/2018 |
Provider Practice Location
4000 E MAIN ST
COLUMBUS
OH
432132950
Practice Location Phone/Fax
| Phone: | 6143346903 |
| Fax: |
Provider Mailing Location
4000 E MAIN ST
COLUMBUS
OH
432132950
Provider Mailing Phone/Fax
| Phone: | 6143346903 |
| Fax: |