Healthcare Provider Details

I. General information

NPI: 1578921458
Provider Name (Legal Business Name): HOLLY TOENSING
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2016
Last Update Date: 02/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7140 OFFICE PARK DR
LIBERTY TOWNSHIP OH
45069-2261
US

IV. Provider business mailing address

1679 BRACHMAN AVE
CINCINNATI OH
45230-2007
US

V. Phone/Fax

Practice location:
  • Phone: 513-777-2426
  • Fax: 513-777-0017
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.0900630
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: