| NPI | 1205077336 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAUREEN MARX Office Manager 419-866-2830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35999) |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: OH 35999) |
| Enumeration Date | 2009-03-19 |
| Last Update Date | 2010-11-17 |