Healthcare Provider Details

I. General information

NPI: 1306268636
Provider Name (Legal Business Name): MARY OENBRINK M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2014
Last Update Date: 01/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 PLEASANT AVE
HAMILTON OH
45015-1133
US

IV. Provider business mailing address

2100 PLEASANT AVE
HAMILTON OH
45015-1133
US

V. Phone/Fax

Practice location:
  • Phone: 513-868-1562
  • Fax: 513-868-1415
Mailing address:
  • Phone: 513-868-1562
  • Fax: 513-868-1415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: