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General NPI Number Information
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NPI Number | 1215810098
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Entity Type | Individual
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Provider Name | AUDREY LAKER LSW
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Gender | Female
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Dates
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Enumeration Date | 07/29/2025
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 3200 EBENEZER RD
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City | CINCINNATI
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State | OH
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Zip | 45248-4038
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Country | US
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Telephone | 513-205-4709
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Fax | 513-636-0810
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Provider Business Mailing Address
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Address Line | 3333 BURNET AVE
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City | CINCINNATI
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State | OH
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Zip | 45229-3039
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Country | US
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Telephone | 513-636-4225
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Fax | 513-636-2511
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | S.2410529
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License Number State | OH
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