Healthcare Provider Details
I. General information
NPI: 1700039302
Provider Name (Legal Business Name): GRETCHEN WARNER MS, PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/28/2008
Last Update Date: 10/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
551 CINCINNATI-BATAVIA PIKE
CINCINNATI OH
45244-1518
US
IV. Provider business mailing address
551 CINCINNATI-BATAVIA PIKE
CINCINNATI OH
45244-1518
US
V. Phone/Fax
- Phone: 513-752-1555
- Fax: 513-753-2144
- Phone: 513-752-1555
- Fax: 513-753-2144
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | C0700930 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: