Healthcare Provider Details

I. General information

NPI: 1740656495
Provider Name (Legal Business Name): KATHERINE SEBRING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHERINE KERN

II. Dates (important events)

Enumeration Date: 08/18/2015
Last Update Date: 08/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 WALL ST SUITE F
CINCINNATI OH
45212-2781
US

IV. Provider business mailing address

2300 WALL ST SUITE F
CINCINNATI OH
45212-2781
US

V. Phone/Fax

Practice location:
  • Phone: 513-834-7063
  • Fax: 513-429-4939
Mailing address:
  • Phone: 513-834-7063
  • Fax: 513-429-4939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberC.1000025
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: