Provider Demographics
NPI:1679544654
Name:GIESSL, IRENE B (EDD)
Entity Type:Individual
Prefix:DR
First Name:IRENE
Middle Name:B
Last Name:GIESSL
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9900 CARVER RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-5523
Mailing Address - Country:US
Mailing Address - Phone:513-221-2001
Mailing Address - Fax:
Practice Address - Street 1:9900 CARVER RD
Practice Address - Street 2:SUITE 101
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-5523
Practice Address - Country:US
Practice Address - Phone:513-221-2001
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3371103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0800459Medicaid
OH0800459Medicaid