| NPI | 1184722126 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES P. REARDON Owner 614-436-9985 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OH 2564) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling (Licence: OH 2564) |
| 103TF0200X Psychologist Forensic (Licence: OH 2564) | |
| 103TR0400X Psychologist Rehabilitation (Licence: OH 2564) | |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2008-06-30 |