Provider Demographics
NPI:1164567251
Name:DICHIARA, JEANNINE MARIE (MS)
Entity Type:Individual
Prefix:MRS
First Name:JEANNINE
Middle Name:MARIE
Last Name:DICHIARA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7804 COLTON LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-2302
Mailing Address - Country:US
Mailing Address - Phone:513-745-0922
Mailing Address - Fax:
Practice Address - Street 1:5630 BRIDGETOWN RD STE 4
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45248-4346
Practice Address - Country:US
Practice Address - Phone:513-598-5102
Practice Address - Fax:513-598-5104
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA01528231H00000X
IN23002385A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist