Healthcare Provider Details

I. General information

NPI: 1801162748
Provider Name (Legal Business Name): TINA KAMINSKY, PH.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2012
Last Update Date: 03/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 E HOLLISTER ST
CINCINNATI OH
45219-1704
US

IV. Provider business mailing address

26 E HOLLISTER ST
CINCINNATI OH
45219-1704
US

V. Phone/Fax

Practice location:
  • Phone: 513-621-5001
  • Fax: 513-621-5008
Mailing address:
  • Phone: 513-621-5001
  • Fax: 513-621-5008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number2763
License Number StateOH

VIII. Authorized Official

Name: TINA KAMINSKY
Title or Position: OWNER
Credential: PH.D.
Phone: 513-621-5001