Healthcare Provider Details

I. General information

NPI: 1306779517
Provider Name (Legal Business Name): KATHRYN AUDREY ZANNINO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7243 EASTLAWN DR
CINCINNATI OH
45237-3515
US

IV. Provider business mailing address

4243 BRIARWOOD DR APT 4
INDEPENDENCE KY
41051-9529
US

V. Phone/Fax

Practice location:
  • Phone: 513-740-1001
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberC60024862
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: