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NPI Code Detail

MEDICARE: MRS. CANDACE L ULITZSCH LISW

MEDICARE: MRS. CANDACE L ULITZSCH LISW
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 WorkerI.0009020OH

General Provider Information

NPI Number : 1568674349
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CANDACE L ULITZSCH LISW
Provider Business Mailing Address
First Line : 3830 CUNNINGHAM CT
Second Line :
City : HAMILTON
State : OH
Zip : 45011-1121
Country : US
Telephone Number : 513-894-7415
Fax Number :
Provider Business Practice Location Address
First Line : 1327 E KEMPER RD STE A&B
Second Line :
City : CINCINNATI
State : OH
Zip : 45246-3945
Country : US
Telephone Number : 513-428-2035
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2007
Last Update Date : 07/17/2024

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