Healthcare Provider Details

I. General information

NPI: 1649944893
Provider Name (Legal Business Name): CASANDRA L MCLIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2021
Last Update Date: 08/02/2021
Certification Date: 08/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6134 WEBBLAND PL
CINCINNATI OH
45213-1406
US

IV. Provider business mailing address

4531 READING RD
CINCINNATI OH
45229-1229
US

V. Phone/Fax

Practice location:
  • Phone: 513-531-1570
  • Fax:
Mailing address:
  • Phone: 513-961-3292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: