Individual
DEBRA J HACKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW, LICDC
Contact information
Practice address
4659 KUGLER MILL RD, CINCINNATI, OH 45236-1913
(513) 403-0648
Mailing address
3805 EDWARDS RD, CINCINNATI, OH 45209-1900
(513) 403-0648
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
923349
OH
1041C0700X
Clinical Social Worker
Primary
I7205
OH
Other
Enumeration date
04/01/2013
Last updated
04/01/2013
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