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General NPI Number Information
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NPI Number | 1427246073
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Entity Type | Individual
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Provider Name | CASIE GERMAIN DORKO M.S., LSW
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Gender | Female
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Dates
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Enumeration Date | 10/09/2007
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Last Update Date | 10/09/2007
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Provider Practice Location Address
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Address Line | 3740 GLENWAY AVE
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City | CINCINNATI
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State | OH
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Zip | 45205-1354
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Country | US
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Telephone | 513-354-5636
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Fax |
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Provider Business Mailing Address
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Address Line | 7112 GRANTHAM WAY
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City | CINCINNATI
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State | OH
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Zip | 45230-2213
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Country | US
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Telephone | 513-258-4103
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Fax |
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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 | S0701211
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License Number State | OH
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