Healthcare Provider Details

I. General information

NPI: 1154593382
Provider Name (Legal Business Name): STEPHANIE R LOCKHART MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2008
Last Update Date: 11/24/2021
Certification Date: 11/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3113 BELLEVUE AVE
CINCINNATI OH
45219-3158
US

IV. Provider business mailing address

2830 VICTORY PARKWAY PAYOR ENROLLMENT
CINCINNATI OH
45206-1785
US

V. Phone/Fax

Practice location:
  • Phone: 513-475-8400
  • Fax: 513-475-8228
Mailing address:
  • Phone: 513-585-5507
  • Fax: 513-585-5511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberA.01215
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: