| NPI | 1689979353 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN K KAHLE Provider/ Sole Member 937-901-3122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OH 5806) |
| Enumeration Date | 2011-01-11 |
| Last Update Date | 2011-01-11 |