| NPI | 1780136267 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARISA CHRISTIN BORGERT Clinical Psychologist/Owner 937-294-6004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: OH 6814) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2016-10-31 |
| Last Update Date | 2016-11-09 |