| NPI | 1285245522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | D'ANDRIA A. A JACKSON Owner/Licensed Clinical Psychologis 614-665-5100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2020-08-11 |
| Last Update Date | 2020-08-11 |