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NPI Code Detail

MEDICARE: ERICA MARIE CRISP MSW

MEDICARE: ERICA MARIE CRISP MSW
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 WorkerS.0027637OH

General Provider Information

NPI Number : 1811495112
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERICA MARIE CRISP MSW
Provider Business Mailing Address
First Line : 7162 READING RD STE 900
Second Line :
City : CINCINNATI
State : OH
Zip : 45237-3879
Country : US
Telephone Number : 513-559-3174
Fax Number :
Provider Business Practice Location Address
First Line : 7162 READING RD STE 900
Second Line :
City : CINCINNATI
State : OH
Zip : 45237-3879
Country : US
Telephone Number : 513-559-3174
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2018
Last Update Date : 02/01/2018

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