Provider Demographics
NPI:1093844730
Name:GOSLEE, CYNTHIA M (LISW)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:M
Last Name:GOSLEE
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3345 WHITFIELD AVE # 2
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45220-2053
Mailing Address - Country:US
Mailing Address - Phone:513-325-0680
Mailing Address - Fax:513-665-7746
Practice Address - Street 1:3345 WHITFIELD AVE # 2
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45220-2053
Practice Address - Country:US
Practice Address - Phone:513-325-0680
Practice Address - Fax:513-665-7746
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH00056201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical