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NPI Code Detail

MEDICARE: GINA MCDONALD

MEDICARE: GINA MCDONALD
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
11041C0700XClinical Social WorkerI0900235OH

General Provider Information

NPI Number : 1235689399
Entity Type Code : Individual
Provider Name (Legal Business Name) : GINA MCDONALD
Provider Business Mailing Address
First Line : 2729 ARBOR AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45209-2206
Country : US
Telephone Number : 513-807-5232
Fax Number :
Provider Business Practice Location Address
First Line : 2729 ARBOR AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45209-2206
Country : US
Telephone Number : 513-807-5232
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2016
Last Update Date : 10/12/2016

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