MEDICARE: FINESHA M OWENSBY

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
1	103TA0700X	Adult Development & Aging Psychologist

General Provider Information

NPI Number	:	1275365223
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FINESHA M OWENSBY

Provider Business Mailing Address
First Line	:	1599 TREMONT ST
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45214-1433
Country	:	US
Telephone Number	:	513-615-9790
Fax Number	:

Provider Business Practice Location Address
First Line	:	1599 TREMONT ST
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45214-1433
Country	:	US
Telephone Number	:	513-615-9790
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2024
Last Update Date	:	08/19/2024

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