Provider Information for 1174088223
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STEPHANIE RENEE GWINN LPCC
Sex: Female
NPI: 1174088223
Last Updated: 2023-01-23
Certification Date: 2023-01-23
Certification Date: 2023-01-23
Details
| Name | Value | ||||||||||||||||
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| NPI | 1174088223 | ||||||||||||||||
| Enumeration Date | 2019-02-04 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | NO | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 4600 MONTGOMERY RD STE 400 CINCINNATI, OH 45212-2600 United States Phone: | Fax: | ||||||||||||||||
| Primary Practice Address | 2645 N LAUREL RD STE A LONDON, KY 40741-9075 United States Phone: 833-510-4357 | Fax: | ||||||||||||||||
| Secondary Practice Address(es) | 21 MIDDLEGROUND WAY 189 HIGHWAY 192 W 225 E PEACHTREE ST STE 2 | ||||||||||||||||
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