Individual
MRS. HAYLEY FAHRNBACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
1501 MADISON RD, WALNUT HILLS, OH 45206-1706
(513) 354-7100
Mailing address
3813 OLEARY AVE, DEER PARK, OH 45236
(513) 376-1553
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I.2102828
OH
1041C0700X
Clinical Social Worker
S.1802885
OH
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000
LICENSURE
—
Enumeration date
12/20/2017
Last updated
08/03/2021
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