Individual
MICHAEL SHAUN PERCIFUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3095 KETTERING BLVD, MORAINE, OH 45439-1983
(937) 913-1902
Mailing address
8908 PEMBROOKE ST, MAINEVILLE, OH 45039-9291
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
P.07606
OH
Other
Enumeration date
11/27/2012
Last updated
09/14/2017
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