Healthcare Provider Details

I. General information

NPI: 1114373701
Provider Name (Legal Business Name): CASSANDRA ESPOSITO PLMHP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2016
Last Update Date: 12/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE ML 3015
CINCINNATI OH
45229-3026
US

IV. Provider business mailing address

3333 BURNET AVE ML 3015
CINCINNATI OH
45229-3026
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-4336
  • Fax: 513-636-7756
Mailing address:
  • Phone: 513-636-4336
  • Fax: 513-636-7756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number10857
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberP.07681
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: