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General NPI Number Information
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NPI Number | 1780499558
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Entity Type | Individual
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Provider Name | JAMIE ANDERCHUK
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Gender | Female
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Dates
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Enumeration Date | 02/10/2025
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 8809B CINCINNATI DAYTON RD
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City | WEST CHESTER
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State | OH
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Zip | 45069-3134
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Country | US
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Telephone | 513-360-8215
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Fax |
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Provider Business Mailing Address
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Address Line | 4969 AERO PKWY APT 104
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City | FLORENCE
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State | KY
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Zip | 41042-3596
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Country | US
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Telephone | 541-730-8924
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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 | S.2504148-TRNE
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License Number State | OH
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