Provider Demographics
NPI:1730889098
Name:RICHARDSON, TORIE A (CHW)
Entity type:Individual
Prefix:
First Name:TORIE
Middle Name:A
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1541 RICHMOND RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43223-3369
Mailing Address - Country:US
Mailing Address - Phone:614-966-2549
Mailing Address - Fax:
Practice Address - Street 1:1541 RICHMOND RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43223-3369
Practice Address - Country:US
Practice Address - Phone:614-966-2549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCHW.001761172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker