Organization
BEHAVIORAL CONSULTANTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT DALTON PH.D. (DIRECTOR)
(614) 975-1675
Entity
Organization
Contact information
Practice address
11206 WOODTOWN RD, GALENA, OH 43021-9638
(614) 923-2585
(614) 923-2585
Mailing address
11206 WOODTOWN RD, GALENA, OH 43021-9638
(614) 923-2585
(614) 923-2585
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
6606
OH
103TA0700X
Adult Development & Aging Psychologist
6606
OH
103TC0700X
Clinical Psychologist
Primary
6606
OH
103TR0400X
Rehabilitation Psychologist
6606
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BE9388601
MEDICARE PTAN
OH
Enumeration date
06/02/2010
Last updated
12/02/2015
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