| NPI | 1790222370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSE MARY SHAW Clinical Psychologist/Owner 937-769-5019 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E0600045) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OH 6323) |
| Enumeration Date | 2017-01-20 |
| Last Update Date | 2017-12-04 |