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5300 Harroun Rd Suite 202 Sylvania OH 43560-2182 | |
| (419) 824-6350 | |
| (419) 885-3847 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 5300 Harroun Rd, Sylvania, Ohio |
| Authorized Official Name and Position | Amy L Bahnsen (CREDENTIALING SUPERVISOR) |
| Authorized Official Contact | 4198247334 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5300 Harroun Rd Suite 202 Sylvania OH 43560-2182 Ph: (419) 824-6350 | 5300 Harroun Rd Suite 202 Sylvania OH 43560-2182 Ph: (419) 824-6350 |
| NPI Number | 1699056549 |
|---|---|
| Provider Enumeration Date | 09/06/2011 |
| Last Update Date | 09/06/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699056549 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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