Healthcare Provider Details
I. General information
NPI: 1013105469
Provider Name (Legal Business Name): RACHEL DEANN FITCH LISW-S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/11/2007
Last Update Date: 09/20/2022
Certification Date: 09/20/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11156 CANAL RD
CINCINNATI OH
45241-5815
US
IV. Provider business mailing address
11156 CANAL RD
CINCINNATI OH
45241-5815
US
V. Phone/Fax
- Phone: 513-772-6166
- Fax: 513-772-6177
- Phone: 513-772-6166
- Fax: 513-772-6177
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 1302814 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: