| NPI | 1821266438 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA MARIE GUIBERSON Practice Manager 419-794-0567 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: OH 35084027) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: OH E0002285-S) |
| 104100000X Social Worker (Licence: OH S0017942) | |
| 1041C0700X Social Worker Clinical (Licence: OH I7740-S) | |
| 1041C0700X Social Worker Clinical (Licence: OH I0010140-S) | |
| 1041C0700X Social Worker Clinical (Licence: OH I0009674) | |
| 1041C0700X Social Worker Clinical (Licence: OH I0002506-S) | |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: OH 35084081) | |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: OH 35078243) | |
| Enumeration Date | 2008-02-16 |
| Last Update Date | 2023-02-23 |