Organization
BOWLING GREEN STATE UNIVERSITY
Active
Other names
Psychological Services Center
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA KELSO (ADMINISTRATIVE ASSISTANT)
(419) 372-2540
Entity
Organization
Contact information
Practice address
822 E MERRY STREET BOWLING GREEN STATE UNIVERSITY, 300 PSYCHOLOGY BUILDING, BOWLING GREEN, OH 43403
(419) 372-2540
(419) 372-2533
Mailing address
822 E MERRY STREET BOWLING GREEN STATE UNIVERSITY, 300 PSYCHOLOGY BUILDING, BOWLING GREEN, OH 43403-0232
(419) 372-2540
(419) 372-2533
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6697
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0747240
—
OH
Enumeration date
09/02/2010
Last updated
07/18/2018
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