Healthcare Provider Details

I. General information

NPI: 1891563060
Provider Name (Legal Business Name): JULIAN HAMDALH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2023
Last Update Date: 12/18/2023
Certification Date: 12/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2347 VINE ST
CINCINNATI OH
45219-1745
US

IV. Provider business mailing address

222 SENATOR PL APT 62
CINCINNATI OH
45220-1724
US

V. Phone/Fax

Practice location:
  • Phone: 513-621-1117
  • Fax:
Mailing address:
  • Phone: 419-508-9146
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: