| NPI | 1568677615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EUGENE BAUER Director 330-361-7023 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 102L00000X Psychoanalyst (Licence: OH C0007913) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: OH C0007913) |
| 171000000X Military Health Care Provider (Licence: OH C0007913) | |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2012-01-09 |