Healthcare Provider Details

I. General information

NPI: 1245049030
Provider Name (Legal Business Name): MS. CAREN PAIDAMOYO KUDZOTSA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2025
Last Update Date: 01/06/2025
Certification Date: 01/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CATHOLIC CHARITIES OF SOUTHWESTERN OHIO 7162 READING RD
CINCINATTI OH
45237
US

IV. Provider business mailing address

2523 REDSTART DR
FAIRFIELD OH
45014-4917
US

V. Phone/Fax

Practice location:
  • Phone: 513-690-2452
  • Fax:
Mailing address:
  • Phone: 513-690-2452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2404048-TRNE
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: