MEDICARE: WILLIAM BUNDY

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
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1588488357
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM BUNDY

Provider Business Mailing Address
First Line	:	10804 LAKEHURST CT
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45242-3109
Country	:	US
Telephone Number	:	513-280-3400
Fax Number	:

Provider Business Practice Location Address
First Line	:	10804 LAKEHURST CT
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45242-3109
Country	:	US
Telephone Number	:	513-280-3400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2024
Last Update Date	:	11/08/2024

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Directions to “ WILLIAM BUNDY ” Practice Location

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