Provider Demographics
NPI:1184994881
Name:DALE, CATHY D (LPN)
Entity type:Individual
Prefix:MRS
First Name:CATHY
Middle Name:D
Last Name:DALE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:222 PIEDMONT AVE
Mailing Address - Street 2:SUITE 5200
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-4231
Mailing Address - Country:US
Mailing Address - Phone:513-475-8400
Mailing Address - Fax:513-475-8228
Practice Address - Street 1:7700 UNIVERSITY CT
Practice Address - Street 2:3900
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-6542
Practice Address - Country:US
Practice Address - Phone:513-475-8400
Practice Address - Fax:513-475-8228
Is Sole Proprietor?:No
Enumeration Date:2012-01-11
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHPN-145108207KI0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KI0005XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyClinical & Laboratory Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHPN-145108Medicaid