| NPI | 1104133289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE WUNDERLE BOSLEY Owner 740-881-4394 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TR0400X Psychologist, Rehabilitation (Licence: OH 3738) |
| Enumeration Date | 2010-09-09 |
| Last Update Date | 2010-09-09 |