Healthcare Provider Details

I. General information

NPI: 1093957268
Provider Name (Legal Business Name): REGENA HARDY MSW, LSW, LCDCIII
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2009
Last Update Date: 04/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2208 READING RD
CINCINNATI OH
45202-1420
US

IV. Provider business mailing address

2208 READING RD
CINCINNATI OH
45202-1420
US

V. Phone/Fax

Practice location:
  • Phone: 513-651-4142
  • Fax: 513-651-2310
Mailing address:
  • Phone: 513-651-4142
  • Fax: 513-651-2310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0801057
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: