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NPI 1730918079

NPI 1730918079 : CATREECE CANNON SWT : FAIRFIELD, OH

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General NPI Number Information
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    NPI Number           |    1730918079
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    Entity Type          |    Individual 
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    Provider Name        |    CATREECE CANNON SWT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/26/2024
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    Last Update Date     |    08/19/2025
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Provider Practice Location Address
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    Address Line         |    1251 NILLES RD STE 5 
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    City                 |    FAIRFIELD
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    State                |    OH
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    Zip                  |    45014-7205
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    Country              |    US
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    Telephone            |    513-939-0300
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2007 WINDMILL WAY 
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    City                 |    CINCINNATI
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    State                |    OH
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    Zip                  |    45240-3343
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    Country              |    US
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    Telephone            |    513-679-0470
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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       |    
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    License Number State |    
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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       |    S.2403711-TRNE
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    License Number State |    OH
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