Healthcare Provider Details

I. General information

NPI: 1336973163
Provider Name (Legal Business Name): KATHERINE RICHARDSON ED.S, NCSP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2024
Last Update Date: 08/26/2024
Certification Date: 08/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1743 ADAMS RD
MOUNT HEALTHY OH
45231-3134
US

IV. Provider business mailing address

1743 ADAMS RD
MOUNT HEALTHY OH
45231-3134
US

V. Phone/Fax

Practice location:
  • Phone: 513-728-4975
  • Fax:
Mailing address:
  • Phone: 513-728-4975
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberOH3500296
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: