| NPI | 1417398587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA B WALLENBROCK Owner 614-432-6410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35049858) |
| Enumeration Date | 2013-07-17 |
| Last Update Date | 2013-07-17 |