| NPI | 1548371032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY BERNARD KELLEY Counseling Psychologist 440-349-5445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: OH 2187) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: OH 2187) |
| 103TS0200X Psychologist, School (Licence: OH 2187) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2021-10-25 |