Healthcare Provider Details

I. General information

NPI: 1306327788
Provider Name (Legal Business Name): MARIA A MANGIONE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2018
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5332 RAPID RUN RD
CINCINNATI OH
45238-4244
US

IV. Provider business mailing address

5332 RAPID RUN RD
CINCINNATI OH
45238-4244
US

V. Phone/Fax

Practice location:
  • Phone: 513-998-6097
  • Fax: 513-995-2053
Mailing address:
  • Phone: 513-998-6097
  • Fax: 513-995-2053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberE.2102534-SUPV
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: