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Individual

ELIZABETH FEARN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
680 NORTHLAND BLVD, CINCINNATI, OH 45240-3248
(513) 941-4999
(513) 694-0168
Mailing address
6460 HARRISON AVE STE 200, CINCINNATI, OH 45247-7958
(513) 941-4999
(513) 694-0168

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDCA.163804
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDCA.167020
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCDCIII.161902
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0366560
OH
Enumeration date
05/17/2019
Last updated
12/04/2024
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