| NPI | 1861807927 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD D. VICKERY Sole Owner 513-791-8849 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OH 6807) |
| Enumeration Date | 2014-06-27 |
| Last Update Date | 2014-06-27 |