| Bowling Green State University | |
|
Psychological Services Center Suite 300 Psychology Dept. Bowling Green State Univ Bowling Green OH 43403 | |
| (419) 372-2540 | |
| (419) 372-2533 |
| Full Name | Bowling Green State University |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | Psychological Services Center, Bowling Green, Ohio |
| Authorized Official Name and Position | Theresa K Kelso (ADMINISTRATIVE ASSISTANT) |
| Authorized Official Contact | 4193722540 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bowling Green State University Psychological Services Center Suite 300 Psychology Dept. Bowling Green State Univ Bowling Green OH 43403-0001 Ph: (419) 372-2540 | Bowling Green State University Psychological Services Center Suite 300 Psychology Dept. Bowling Green State Univ Bowling Green OH 43403 Ph: (419) 372-2540 |
| NPI Number | 1366409690 |
|---|---|
| Provider Enumeration Date | 04/28/2006 |
| Last Update Date | 06/18/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366409690 | NPI | - | NPPES |
| 0747240 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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