Healthcare Provider Details

I. General information

NPI: 1821490814
Provider Name (Legal Business Name): WILLIAM BENTLEY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2014
Last Update Date: 09/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8101 HAMILTON AVE
CINCINNATI OH
45231-2323
US

IV. Provider business mailing address

7615 HARRISON AVE
MOUNT HEALTHY OH
45231-3107
US

V. Phone/Fax

Practice location:
  • Phone: 513-728-4979
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: