Healthcare Provider Details

I. General information

NPI: 1992212864
Provider Name (Legal Business Name): CATHERINE CONNOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2018
Last Update Date: 02/10/2022
Certification Date: 02/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 MADISON RD
WALNUT HILLS OH
45206-1706
US

IV. Provider business mailing address

1501 MADISON RD
WALNUT HILLS OH
45206-1706
US

V. Phone/Fax

Practice location:
  • Phone: 513-354-7100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.2102255
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: