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General NPI Number Information
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NPI Number | 1174829105
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Entity Type | Individual
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Provider Name | JENNIFER L DEGOUVEA-PINTO PSY.D
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Gender | Female
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Dates
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Enumeration Date | 02/09/2011
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Last Update Date | 02/09/2011
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Provider Practice Location Address
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Address Line | 4760 MADISON RD
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City | CINCINNATI
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State | OH
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Zip | 45227-1426
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Country | US
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Telephone | 513-321-8286
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Fax | 513-872-5783
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Provider Business Mailing Address
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Address Line | 2600 VICTORY PKWY
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City | CINCINNATI
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State | OH
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Zip | 45206-1711
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Country | US
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Telephone | 513-751-7747
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Fax | 513-751-0180
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6173
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License Number State | OH
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