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8315 Montgomery Road Cincinnati OH 45236-2227 | |
| (513) 794-9144 | |
| (513) 794-1083 |
| Full Name | |
|---|---|
| Speciality | Psychologist |
| Location | 8315 Montgomery Road, Cincinnati, Ohio |
| Authorized Official Name and Position | Justin Thomas Devoge (CO OWNER) |
| Authorized Official Contact | 5137949144 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
8315 Montgomery Road Cincinnati OH 45236-2227 Ph: (513) 794-9144 | 8315 Montgomery Road Cincinnati OH 45236-2227 Ph: (513) 794-9144 |
| NPI Number | 1558436543 |
|---|---|
| Provider Enumeration Date | 11/22/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558436543 | NPI | - | NPPES |
| 00000030185Z | Other | ANTHEM BCBS | |
| 232722014004 | Other | MEDICAL MUTUAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 832 (Ohio) | Primary |
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