Provider Demographics
NPI:1396333548
Name:RICHARDSON, MAURICE LEE
Entity type:Individual
Prefix:
First Name:MAURICE
Middle Name:LEE
Last Name:RICHARDSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9658 FERNBROOK CT
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-3705
Mailing Address - Country:US
Mailing Address - Phone:513-608-2876
Mailing Address - Fax:
Practice Address - Street 1:9658 FERNBROOK CT
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-3705
Practice Address - Country:US
Practice Address - Phone:513-608-2876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-04
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health