Healthcare Provider Details

I. General information

NPI: 1528622859
Provider Name (Legal Business Name): ABBY LONNEMANN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2019
Last Update Date: 03/06/2026
Certification Date: 03/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE
CINCINNATI OH
45229-3026
US

IV. Provider business mailing address

1230 CORNERSTONE BLVD APT 356
DOWNINGTOWN PA
19335-5357
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-3185
  • Fax:
Mailing address:
  • Phone: 859-866-6542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberP.08044
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: