Provider Demographics
NPI:1093449308
Name:DULLE, MADELINE L (LSW)
Entity Type:Individual
Prefix:
First Name:MADELINE
Middle Name:L
Last Name:DULLE
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2128 ALPINE PL APT 3
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45206-2669
Mailing Address - Country:US
Mailing Address - Phone:513-679-0418
Mailing Address - Fax:
Practice Address - Street 1:2128 ALPINE PL APT 3
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45206-2669
Practice Address - Country:US
Practice Address - Phone:513-679-0418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHS.1802710OtherLICENSED SOCIAL WORKER