Healthcare Provider Details

I. General information

NPI: 1821849308
Provider Name (Legal Business Name): ANGE LENINE IRADUKUNDA RUKEBESHA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2024
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 MADISON RD BASEMENT LEVEL
CINCINNATI OH
45206
US

IV. Provider business mailing address

2340 AUBURN AVE
CINCINNATI OH
45219
US

V. Phone/Fax

Practice location:
  • Phone: 513-354-5200
  • Fax:
Mailing address:
  • Phone: 513-354-5200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: