| NPI | 1801291752 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINALD C BLUE Chief Operating Officer 440-523-0088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OH 2166) |
| Enumeration Date | 2014-11-04 |
| Last Update Date | 2017-04-03 |