Healthcare Provider Details

I. General information

NPI: 1982102349
Provider Name (Legal Business Name): NATALIE MARIE STRZOK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2018
Last Update Date: 09/03/2020
Certification Date: 09/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 FULTON AVE
CINCINNATI OH
45206-2504
US

IV. Provider business mailing address

4210 LONG ACRES DR APT F
CINCINNATI OH
45245-1635
US

V. Phone/Fax

Practice location:
  • Phone: 513-961-4663
  • Fax:
Mailing address:
  • Phone: 812-621-1985
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE.2001762
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: