Organization
CROOKED RIVER PSYCHOLOGY ASSOCIATES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHELLE OGILVIE HILS PSY.D. (OWNER)
(216) 346-3794
Entity
Organization
Contact information
Practice address
375 HARBOR CT, AVON LAKE, OH 44012-2489
(216) 346-3794
Mailing address
PO BOX 750834, FOREST HILLS, NY 11375-0834
(718) 268-6600
(718) 268-6065
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
5259
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5259
PROFESSIONAL PSYCHOLOGY LICENSE
OH
Enumeration date
02/02/2015
Last updated
02/02/2015
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