Healthcare Provider Details

I. General information

NPI: 1619969268
Provider Name (Legal Business Name): FRANCES A REPKA ED.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2005
Last Update Date: 08/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2330 VICTORY PKWY STE 500
CINCINNATI OH
45206-2839
US

IV. Provider business mailing address

2330 VICTORY PKWY STE 500
CINCINNATI OH
45206-2839
US

V. Phone/Fax

Practice location:
  • Phone: 513-221-2330
  • Fax: 513-221-8954
Mailing address:
  • Phone: 513-221-2330
  • Fax: 513-221-8954

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number4022
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: