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General NPI Number Information
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NPI Number | 1306463484
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Entity Type | Individual
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Provider Name | MARYANNA CAMILLE SPERDUTO MSW , LISW-S
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Gender | Female
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Dates
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Enumeration Date | 07/06/2020
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Last Update Date | 01/02/2026
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Provider Practice Location Address
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Address Line | 1916 DRAKE RD
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City | LEBANON
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State | OH
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Zip | 45036-8624
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Country | US
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Telephone | 513-934-5100
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Fax | 513-933-2150
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Provider Business Mailing Address
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Address Line | 3333 BURNET AVE ML 5021
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 19580
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | I.2304979-SUPV
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License Number State | OH
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