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General NPI Number Information
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NPI Number | 1659722858
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Entity Type | Individual
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Provider Name | EMILY M WANSTRATH LISW
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Gender | Female
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Dates
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Enumeration Date | 06/29/2016
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Last Update Date | 06/29/2016
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Provider Practice Location Address
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Address Line | 8044 MONTGOMERY RD SUITE 700
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City | CINCINNATI
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State | OH
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Zip | 45236-2919
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Country | US
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Telephone | 513-907-6238
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Fax | 844-965-9287
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Provider Business Mailing Address
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Address Line | 4116 PAXTON WOODS DR
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City | CINCINNATI
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State | OH
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Zip | 45209-1417
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Country | US
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Telephone | 513-442-9170
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I1600252
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License Number State | OH
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