| NPI | 1053589135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE S WAGNER Managing Partner 216-548-5469 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OH 6025) |
| Enumeration Date | 2008-02-12 |
| Last Update Date | 2008-02-12 |