Healthcare Provider Details

I. General information

NPI: 1295402618
Provider Name (Legal Business Name): BRIANA M PROFFITT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2021
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5050 MADISON RD
CINCINNATI OH
45227-1491
US

IV. Provider business mailing address

10 WESTWOOD DR APT 2D
FAIRFIELD OH
45014-6421
US

V. Phone/Fax

Practice location:
  • Phone: 513-272-2800
  • Fax:
Mailing address:
  • Phone: 513-462-4781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberUL142217
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: