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General NPI Number Information
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NPI Number | 1306164678
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Entity Type | Individual
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Provider Name | FELISHA EARLS LSW
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Gender | Female
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Dates
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Enumeration Date | 05/12/2010
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Last Update Date | 11/29/2011
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Provider Practice Location Address
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Address Line | 759 COLUMBUS AVE
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City | LEBANON
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State | OH
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Zip | 45036-1754
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Country | US
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Telephone | 513-932-4337
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Fax | 513-751-7747
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | S.1000971
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License Number State | OH
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