Provider Demographics
NPI:1922185206
Name:ESQUIVEL-LYNCH, GLORIA MARIE (LISW-S)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:MARIE
Last Name:ESQUIVEL-LYNCH
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 62
Mailing Address - Street 2:
Mailing Address - City:WAPAKONETA
Mailing Address - State:OH
Mailing Address - Zip Code:45895-0062
Mailing Address - Country:US
Mailing Address - Phone:419-739-7002
Mailing Address - Fax:
Practice Address - Street 1:404 HAMILTON RD STE 4
Practice Address - Street 2:
Practice Address - City:WAPAKONETA
Practice Address - State:OH
Practice Address - Zip Code:45895-1156
Practice Address - Country:US
Practice Address - Phone:419-739-7002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI0010084104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker