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General NPI Number Information
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NPI Number | 1881406346
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Entity Type | Organization
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Legal Business Name | SUPER SEEDS
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Dates
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Enumeration Date | 01/22/2025
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 10142 SPRINGFIELD PIKE
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City | CINCINNATI
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State | OH
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Zip | 45215-1449
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Country | US
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Telephone | 513-549-1516
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Fax | 800-462-8501
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Provider Business Mailing Address
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Address Line | 10142 SPRINGFIELD PIKE
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City | CINCINNATI
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State | OH
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Zip | 45215-1449
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Country | US
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Telephone | 513-549-1516
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Fax | 800-462-8501
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. CANDICE R TOLBERT
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Credential |
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Telephone | 513-543-4275
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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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 | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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