Healthcare Provider Details

I. General information

NPI: 1023931615
Provider Name (Legal Business Name): AISHA IFA MOIEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2026
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7591 TYLERS PLACE BLVD
WEST CHESTER OH
45069-6308
US

IV. Provider business mailing address

6614 RIVER BIRCH CT
LIBERTY TOWNSHIP OH
45044-8890
US

V. Phone/Fax

Practice location:
  • Phone: 513-755-6600
  • Fax: 513-838-5292
Mailing address:
  • Phone: 513-913-0104
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: