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General NPI Number Information
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NPI Number | 1255294666
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Entity Type | Organization
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Legal Business Name | FIERCELY REDEFINED DANCE TEAM
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Dates
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Enumeration Date | 12/03/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 9535 PIPPIN RD
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City | CINCINNATI
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State | OH
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Zip | 45231-2221
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Country | US
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Telephone | 513-407-8005
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Fax |
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Provider Business Mailing Address
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Address Line | 8304 SEA MIST CT
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City | WEST CHESTER
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State | OH
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Zip | 45069-9252
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Country | US
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Telephone | 513-407-8005
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARKESHA ANN WILLIAMS
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Credential |
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Telephone | 513-885-6065
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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