Provider Demographics
NPI:1093148587
Name:HAUSER, KIMBERLY (LISW-S)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:HAUSER
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:
Other - Last Name:BRAUN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:533 COCHISE CT
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:OH
Mailing Address - Zip Code:45215-2519
Mailing Address - Country:US
Mailing Address - Phone:513-891-0650
Mailing Address - Fax:
Practice Address - Street 1:4240 HUNT RD
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-6612
Practice Address - Country:US
Practice Address - Phone:513-891-0650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-20
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.00263281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical