Basic Information
| Provider Information | |||||||||
| NPI: | 1407146681 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CASEY-LEAVELL | ||||||||
| FirstName: | BRIDGET | ||||||||
| MiddleName: | ANNE | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1101 SUMMIT RD | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452372621 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5139483600 | ||||||||
| FaxNumber: | 5139483721 | ||||||||
| Practice Location | |||||||||
| Address1: | 1101 SUMMIT RD | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452372621 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5139483600 | ||||||||
| FaxNumber: | 5139483721 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/08/2011 | ||||||||
| LastUpdateDate: | 07/13/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 34.011722 | OH | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.