Provider Demographics
NPI:1992483606
Name:SMITH, NICHOLE ROBIN (MS, CGC, LGC)
Entity type:Individual
Prefix:
First Name:NICHOLE
Middle Name:ROBIN
Last Name:SMITH
Suffix:
Gender:F
Credentials:MS, CGC, LGC
Other - Prefix:
Other - First Name:NICKI
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:375 DIXMYTH AVE
Mailing Address - Street 2:SETON CENTER
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45220
Mailing Address - Country:US
Mailing Address - Phone:513-862-2218
Mailing Address - Fax:513-852-3198
Practice Address - Street 1:375 DIXMYTH AVE
Practice Address - Street 2:SETON CENTER
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45220
Practice Address - Country:US
Practice Address - Phone:513-862-2218
Practice Address - Fax:513-852-3198
Is Sole Proprietor?:No
Enumeration Date:2023-07-11
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH70.000102170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS