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1568438497
RUSSELL W DERN
LEBANON, OH
NPI
1568438497
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: OH 3444)
Enumeration Date
2006-02-28
Last Update Date
2018-05-22
Business Address
Mr. RUSSELL W DERN Ph.D
975 KINGSIVEW DRIVE BLDG A
LEBANON, OH 45036-9562
Phone number: 513-228-7800
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Mailing Address
Mr. RUSSELL W DERN Ph.D
204 COOK RD SUITE 400
LEBANON, OH 45036-9600
Phone number: 513-228-7800
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