Healthcare Provider Details

I. General information

NPI: 1922697929
Provider Name (Legal Business Name): DANIELLE SEYMORE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2021
Last Update Date: 06/23/2024
Certification Date: 05/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8809 CINCINNATI DAYTON RD
WEST CHESTER OH
45069-3134
US

IV. Provider business mailing address

8809B CINCINNATI DAYTON RD
WEST CHESTER OH
45069-3134
US

V. Phone/Fax

Practice location:
  • Phone: 513-360-8205
  • Fax:
Mailing address:
  • Phone: 513-360-8205
  • Fax: 513-620-5645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: