Provider Demographics
NPI:1225628340
Name:PENA KUMPF, MARIA I
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:I
Last Name:PENA KUMPF
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 1:3030 W FORK RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45211-1944
Mailing Address - Country:US
Mailing Address - Phone:513-593-8688
Mailing Address - Fax:
Practice Address - Street 1:3030 W FORK RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-1944
Practice Address - Country:US
Practice Address - Phone:937-712-3121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-22
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty