Provider Demographics
NPI:1881768620
Name:MILLER-PLOETZ, TAMARA (LISW)
Entity type:Individual
Prefix:MRS
First Name:TAMARA
Middle Name:
Last Name:MILLER-PLOETZ
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4790 RED BANK EXPRESSWAY
Mailing Address - Street 2:SUITE 128
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45227-2701
Mailing Address - Country:US
Mailing Address - Phone:513-731-3346
Mailing Address - Fax:513-672-9539
Practice Address - Street 1:2421 AUBURN AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2701
Practice Address - Country:US
Practice Address - Phone:513-731-3346
Practice Address - Fax:513-458-3582
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2018-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI00082731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH11644993OtherAETNA