Healthcare Provider Details

I. General information

NPI: 1194390583
Provider Name (Legal Business Name): LAUREN ELAINE LLUTHER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2021
Last Update Date: 05/26/2021
Certification Date: 05/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 OAK ST
CINCINNATI OH
45219-2504
US

IV. Provider business mailing address

411 OAK ST
CINCINNATI OH
45219-2504
US

V. Phone/Fax

Practice location:
  • Phone: 513-984-1800
  • Fax: 513-984-4909
Mailing address:
  • Phone: 513-984-1800
  • Fax: 513-984-4909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number0000012268
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: