| NPI | 1396977286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETHANY ANN SHAW Clinical Psychologist 614-794-3138 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OH 5212) |
| Enumeration Date | 2009-08-11 |
| Last Update Date | 2023-08-23 |