| NPI | 1811261647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG DOUGLAS OLSON Clinical Psychologist 937-436-5999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OH 4487) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: OH 4487) |
| Enumeration Date | 2012-02-24 |
| Last Update Date | 2024-09-25 |