| NPI | 1508923137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL A FORMAN President 614-263-5908 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OH 2928) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: OH 4417) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2012-10-09 |