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1629715248
KENNETH JAMES SHIVERDECKER
CINCINNATI, OH
NPI
1629715248
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OH CDCA.178622)
Enumeration Date
2022-05-16
Last Update Date
2022-05-16
Business Address
KENNETH JAMES SHIVERDECKER CDCA
3009 BURNET AVE
CINCINNATI, OH 45219-2419
Phone number: 513-872-8880
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Mailing Address
KENNETH JAMES SHIVERDECKER CDCA
2600 VICTORY PKWY
CINCINNATI, OH 45206-1395
Phone number: 513-751-7747
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