Healthcare Provider Details

I. General information

NPI: 1962183137
Provider Name (Legal Business Name): CHRISTIE KEMPER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2023
Last Update Date: 07/31/2023
Certification Date: 07/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7266 FAR HILLS AVE
CENTERVILLE OH
45459-4207
US

IV. Provider business mailing address

2700 SUTTON AVE
KETTERING OH
45429-3743
US

V. Phone/Fax

Practice location:
  • Phone: 513-360-8205
  • Fax:
Mailing address:
  • Phone: 937-903-0428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberS.2208599
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: