Healthcare Provider Details

I. General information

NPI: 1780120618
Provider Name (Legal Business Name): LAURIE E DUNNING
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2017
Last Update Date: 01/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 GLENSPRINGS DR SUITE 201
CINCINNATI OH
45246-2317
US

IV. Provider business mailing address

415 GLENSPRINGS DR SUITE 201
CINCINNATI OH
45246-2317
US

V. Phone/Fax

Practice location:
  • Phone: 513-771-9600
  • Fax: 513-771-2546
Mailing address:
  • Phone: 513-771-9600
  • Fax: 513-771-2546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.1600338
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: