| NPI | 1073902862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEALYNNE ANNE BAUS Clinical Psychologist 419-602-3149 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OH 5908) |
| Enumeration Date | 2015-01-15 |
| Last Update Date | 2015-01-15 |