Provider Demographics
NPI:1124624481
Name:LUNSFORD, ABIONA
Entity type:Individual
Prefix:
First Name:ABIONA
Middle Name:
Last Name:LUNSFORD
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5517 KIRBY AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45239-6869
Mailing Address - Country:US
Mailing Address - Phone:513-557-0793
Mailing Address - Fax:
Practice Address - Street 1:5517 KIRBY AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45239-6869
Practice Address - Country:US
Practice Address - Phone:513-557-0793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-10
Last Update Date:2025-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3123613251C00000X
OHFPS.000129251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3123613OtherD.O.D.D