Connelly, Dina Lee

Connelly, Dina Lee is an individual health care provider with primary practice located at 3050 Mack Rd Ste 205 , Fairfield OH 45014-5376. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / School, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Connelly, Dina Lee can be contacted via phone (513) 682-6980.

Contact Information

Primary practice address
3050 Mack Rd Ste 205 Fairfield OH 45014-5376
Phone: (513) 682-6980
Fax: (513) 981-5783
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 1041S0200X OH3064767 Ohio
Behavioral Health & Social Service Providers / Clinical 1041C0700X 12935 South Carolina
Behavioral Health & Social Service Providers / Clinical 1041C0700X I.1303609-SUPV Ohio

Profile Details

NPI number 1548719966
LBN Legal business name Connelly, Dina Lee
Credentials LISW-CP
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 27th, 2016
Last updated Apr 20th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548719966 NPPES
South Carolina Other 12935 SC MEDICAL LICENSE
South Carolina Other I.1303609.SUPV SC MEDICAL LICENSE

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