Healthcare Provider Details

I. General information

NPI: 1396192183
Provider Name (Legal Business Name): KATHERINE SOE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2016
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE
CINCINNATI OH
45229-3026
US

IV. Provider business mailing address

3333 BURNET AVE MLC3024
CINCINNATI OH
45229-3026
US

V. Phone/Fax

Practice location:
  • Phone: 513-803-3173
  • Fax: 513-803-9244
Mailing address:
  • Phone: 513-803-3173
  • Fax: 513-803-9244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number01083802A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number01083802A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number35.142598
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.142598
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number35.142598
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: