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NPI Code Detail

MEDICARE: MS. MARY J. ROYER LISW

MEDICARE: MS. MARY J. ROYER 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 WorkerI 0003470OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578746806
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARY J. ROYER LISW
Provider Business Mailing Address
First Line : 1900 FAIRGROVE AVE
Second Line :
City : HAMILTON
State : OH
Zip : 45011-1966
Country : US
Telephone Number : 513-868-3210
Fax Number : 513-868-3249
Provider Business Practice Location Address
First Line : 1900 FAIRGROVE AVE
Second Line :
City : HAMILTON
State : OH
Zip : 45011-1966
Country : US
Telephone Number : 513-868-3210
Fax Number : 513-868-3249
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2007
Last Update Date : 12/10/2007

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Directions to “ MS. MARY J. ROYER LISW” Practice Location

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