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NPI Code Detail

MEDICARE: CAITLYN CHEYENNE GAUSMAN LSW

MEDICARE:   CAITLYN CHEYENNE GAUSMAN  LSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial WorkerS.1700212OH

General Provider Information

NPI Number : 1134650260
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAITLYN CHEYENNE GAUSMAN LSW
Provider Business Mailing Address
First Line : 615 ELSINORE PL
Second Line :
City : CINCINNATI
State : OH
Zip : 45202-1459
Country : US
Telephone Number : 513-231-6630
Fax Number :
Provider Business Practice Location Address
First Line : 615 ELSINORE PL
Second Line :
City : CINCINNATI
State : OH
Zip : 45202-1459
Country : US
Telephone Number : 513-231-6630
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2017
Last Update Date : 01/05/2024

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Directions to “ CAITLYN CHEYENNE GAUSMAN LSW” Practice Location

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