Healthcare Provider Details

I. General information

NPI: 1689243883
Provider Name (Legal Business Name): PLOYSUAY KIMURA LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PLOYSUAY WU

II. Dates (important events)

Enumeration Date: 06/22/2021
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10296 SPRINGFIELD PIKE
CINCINNATI OH
45215-1193
US

IV. Provider business mailing address

4861 DUCK CREEK ROAD
CINCINNATI OH
45227-1421
US

V. Phone/Fax

Practice location:
  • Phone: 614-339-1649
  • Fax:
Mailing address:
  • Phone: 513-832-2884
  • Fax: 513-351-1780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: