Provider Demographics
NPI:1659829315
Name:STRITTMATTER, KRISTIE MARIE (ED S)
Entity Type:Individual
Prefix:
First Name:KRISTIE
Middle Name:MARIE
Last Name:STRITTMATTER
Suffix:
Gender:F
Credentials:ED S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11150 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45241-2623
Mailing Address - Country:US
Mailing Address - Phone:513-864-2671
Mailing Address - Fax:
Practice Address - Street 1:11150 MAPLE ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241-2623
Practice Address - Country:US
Practice Address - Phone:513-864-2671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-12
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH1369678103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool