| Kenna R Mycek | |
|
27101 E Oviatt Rd #2 Bay Village OH 44140-3307 | |
| (216) 534-0907 | |
| Not Available |
| Full Name | Kenna R Mycek |
|---|---|
| Speciality | Psychologist - Clinical Child & Adolescent |
| Location | 27101 E Oviatt Rd, Bay Village, Ohio |
| Authorized Official Name and Position | Kenna Mycek (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 2165340907 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kenna R Mycek 27101 E Oviatt Rd #2 Bay Village OH 44140-3307 Ph: (216) 534-0907 | Kenna R Mycek 27101 E Oviatt Rd #2 Bay Village OH 44140-3307 Ph: (216) 534-0907 |
| NPI Number | 1063950269 |
|---|---|
| Provider Enumeration Date | 02/08/2017 |
| Last Update Date | 02/08/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063950269 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC2200X | Psychologist - Clinical Child & Adolescent | RW689718 (Ohio) | Primary |
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