Organization
DIVINE LIFE THERAPEUTIC SOLUTIONS LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EBONY PEAK MSW, LISW-S (THERAPIST)
(513) 238-0761
Entity
Organization
Contact information
Practice address
800 COMPTON RD STE 37B-6, CINCINNATI, OH 45231-3826
(513) 445-2053
Mailing address
1918 STEVENS AVE, CINCINNATI, OH 45231-4222
(513) 238-0761
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
01/30/2024
Last updated
01/30/2024
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