| NPI | 1760052005 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER ELLEN FARRELL Counseling Psychologist 937-765-0654 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling |
| Enumeration Date | 2021-06-29 |
| Last Update Date | 2023-11-13 |