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NPI Code Detail

MEDICARE: MRS. HELENA LYENNA RURA LISW

MEDICARE: MRS. HELENA LYENNA RURA LISW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerI0008538OH

General Provider Information

NPI Number : 1114003167
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. HELENA LYENNA RURA LISW
Provider Business Mailing Address
First Line : 7356 PARKDALE AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45237-3121
Country : US
Telephone Number : 513-558-5378
Fax Number :
Provider Business Practice Location Address
First Line : 311 ALBERT SABIN WAY
Second Line :
City : CINCINNATI
State : OH
Zip : 45229-2801
Country : US
Telephone Number : 513-558-5378
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2006
Last Update Date : 07/08/2007

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Directions to “ MRS. HELENA LYENNA RURA LISW” Practice Location

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