| NPI | 1548501059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN MACKS Licensed Clinical Psychologist 513-204-5746 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OH 6162) |
| Enumeration Date | 2013-03-07 |
| Last Update Date | 2013-05-17 |