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General NPI Number Information
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NPI Number | 1265798706
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Entity Type | Organization
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Legal Business Name | LIFE EXPRESSIONS
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Dates
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Enumeration Date | 04/10/2012
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Last Update Date | 04/10/2012
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Provider Practice Location Address
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Address Line | 10274 ALLIANCE RD
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City | BLUE ASH
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State | OH
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Zip | 45242-4710
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Country | US
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Telephone | 513-631-8900
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Fax | 513-891-9994
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Provider Business Mailing Address
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Address Line | 10274 ALLIANCE RD,
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City | CINCINNATI
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State | OH
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Zip | 45242-4710
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Country | US
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Telephone | 513-631-8900
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Fax | 513-891-9947
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. CAROL J. BRADY
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Credential | LISW
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Telephone | 513-631-8900
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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 | I-0003841
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License Number State | OH
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