| NPI | 1972817104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY ANN STARK-DICKASON Psychologist 740-751-7860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: OH 6546) |
| Enumeration Date | 2010-07-29 |
| Last Update Date | 2010-07-29 |