NPI | 1003388620 |
---|---|
Entity Type | Organization |
Authorized Contact | BETHANY JOY CLOSS Office Manager 419-841-2298 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
207Q00000X Family Medicine | |
207R00000X Internal Medicine | |
Enumeration Date | 2018-12-20 |
Last Update Date | 2018-12-20 |