| NPI | 1891807632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN MARY REDLE Managing Member 330-926-0760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OH 5989) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OH 5555) |
| 103TC0700X Psychologist, Clinical (Licence: OH 5934) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-08-22 |