Provider Demographics
NPI:1497449748
Name:MEADE, KYRA N (LMT)
Entity Type:Individual
Prefix:MRS
First Name:KYRA
Middle Name:N
Last Name:MEADE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MISS
Other - First Name:KYRA
Other - Middle Name:N
Other - Last Name:BERENZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:4653 JOANA PL APT 1
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45238-4578
Mailing Address - Country:US
Mailing Address - Phone:513-952-2416
Mailing Address - Fax:
Practice Address - Street 1:3131 QUEEN CITY AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-2316
Practice Address - Country:US
Practice Address - Phone:513-389-5600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-07
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.021149225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist