Individual
ANTENNIE D AULD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP-PMH
Contact information
Practice address
4212 STATE ROUTE 306 STE 100, WILLOUGHBY, OH 44094-9248
(440) 973-8400
(440) 201-6400
Mailing address
11134 LUSCHEK DR, BLUE ASH, OH 45241-2434
(513) 827-9274
(513) 818-9960
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN.CNP.020969
OH
Other
Enumeration date
07/07/2017
Last updated
09/30/2025
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