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375 Dixmyth Ave Rm 1035-1 Cincinnati OH 45220-2475 | |
| (513) 862-2692 | |
| (513) 862-1584 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 375 Dixmyth Ave, Cincinnati, Ohio |
| Authorized Official Name and Position | Donna S Nienaber (VICE PRESIDENT) |
| Authorized Official Contact | 5138621400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 632895 Cincinnati OH 45263-2895 Ph: (513) 569-5027 | 375 Dixmyth Ave Rm 1035-1 Cincinnati OH 45220-2475 Ph: (513) 862-2692 |
| NPI Number | 1497763593 |
|---|---|
| Provider Enumeration Date | 08/04/2006 |
| Last Update Date | 04/18/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497763593 | NPI | - | NPPES |
| 2284746 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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