Provider Demographics
NPI:1528243581
Name:BISHOP, BIBIANA MARIA (LSW)
Entity type:Individual
Prefix:
First Name:BIBIANA
Middle Name:MARIA
Last Name:BISHOP
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3414 MAUTINO DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-9209
Mailing Address - Country:US
Mailing Address - Phone:614-895-1362
Mailing Address - Fax:614-722-8420
Practice Address - Street 1:3414 MAUTINO DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-9209
Practice Address - Country:US
Practice Address - Phone:614-895-1362
Practice Address - Fax:614-722-8420
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS. 0500253104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker