| |
30 E Apple St Ste 6255 Dayton OH 45409-2939 | |
(937) 208-2554 | |
(937) 208-3893 |
Full Name | |
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Speciality | Psychologist - Clinical |
Location | 30 E Apple St, Dayton, Ohio |
Authorized Official Name and Position | Christopher Danis (CEO/PRESIDENT) |
Authorized Official Contact | 9372082554 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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30 E Apple St Ste 6255 Dayton OH 45409-2939 Ph: (937) 208-2554 | 30 E Apple St Ste 6255 Dayton OH 45409-2939 Ph: (937) 208-2554 |
NPI Number | 1235315169 |
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Provider Enumeration Date | 01/10/2008 |
Last Update Date | 11/07/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1235315169 | NPI | - | NPPES |
2818777 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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