Healthcare Provider Details

I. General information

NPI: 1457282733
Provider Name (Legal Business Name): KODY LEE BARHORST
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

1910 FAIRGROVE AVE STE E
HAMILTON OH
45011-1930
US

IV. Provider business mailing address

1910 FAIRGROVE AVE STE E
HAMILTON OH
45011-1930
US

V. Phone/Fax

Practice location:
  • Phone: 513-494-4679
  • Fax:
Mailing address:
  • Phone: 513-494-4679
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: