Healthcare Provider Details

I. General information

NPI: 1760623136
Provider Name (Legal Business Name): BRANDY ANN MAURER LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2009
Last Update Date: 03/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

328 MCGREGOR AVE
CINCINNATI OH
45219-3135
US

IV. Provider business mailing address

2600 VICTORY PKWY
CINCINNATI OH
45206-1711
US

V. Phone/Fax

Practice location:
  • Phone: 513-684-7968
  • Fax:
Mailing address:
  • Phone: 513-751-7747
  • Fax: 513-872-5182

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.0031980
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: