Healthcare Provider Details
I. General information
NPI: 1700329596
Provider Name (Legal Business Name): SONYA ANN STRUNK LCDC III
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/28/2016
Last Update Date: 11/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7597 BRIDGETOWN RD
CINCINNATI OH
45248-2019
US
IV. Provider business mailing address
7597 BRIDGETOWN RD
CINCINNATI OH
45248-2019
US
V. Phone/Fax
- Phone: 513-491-4999
- Fax: 513-941-7555
- Phone: 513-491-4999
- Fax: 513-941-7555
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | 151190 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: