Basic Information
| Provider Information | |||||||||
| NPI: | 1427179118 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BIDANI | ||||||||
| FirstName: | GARIMA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MISS | ||||||||
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| Credential: | SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8417 SAINT LOUIS BLVD | ||||||||
| Address2: | |||||||||
| City: | UNION | ||||||||
| State: | KY | ||||||||
| PostalCode: | 410917418 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5132812464 | ||||||||
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| Practice Location | |||||||||
| Address1: | 625 PROBASCO ST | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452202710 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5132812464 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/02/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | SP8039 | OH | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.