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General NPI Number Information
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NPI Number | 1073818357
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Entity Type | Organization
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Legal Business Name | CMOODY & ASSOCIATES
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Dates
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Enumeration Date | 01/19/2011
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Last Update Date | 01/19/2011
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Provider Practice Location Address
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Address Line | 3909 DICKSON AVE
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City | CINCINNATI
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State | OH
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Zip | 45229-1339
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Country | US
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Telephone | 513-324-2615
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Fax | 513-751-1322
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Provider Business Mailing Address
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Address Line | 3909 DICKSON AVE
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City | CINCINNATI
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State | OH
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Zip | 45229-1339
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Country | US
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Telephone | 513-324-2615
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Fax | 513-751-1322
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Authorized Official
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Title or Position | CEO
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Name | CONNIE MOODY
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Credential | LISW
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Telephone | 513-324-2615
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I4207-S
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License Number State | OH
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