| NPI | 1003102237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELANIE J HANUS Office Manager 419-936-7575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: OH 62003909) |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2011-06-27 |