Healthcare Provider Details

I. General information

NPI: 1144130550
Provider Name (Legal Business Name): KEARSTEN TRAME
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1685 S MAIN ST
SPRINGBORO OH
45066-1524
US

IV. Provider business mailing address

1685 S MAIN ST
SPRINGBORO OH
45066-1524
US

V. Phone/Fax

Practice location:
  • Phone: 937-748-3960
  • Fax:
Mailing address:
  • Phone: 937-748-3960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberLSP.01503
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: