| NPI | 1447701404 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONYA SCHMIDTZ Credentialing Specialist 513-242-7600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X (Licence: OH E1609) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: OH E1609) |
| Enumeration Date | 2016-10-14 |
| Last Update Date | 2016-10-14 |