Individual
JASON RANDALL DURA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
8165 KEVIN LN, SYLVANIA, OH 43560-1097
(419) 885-2751
(419) 824-0455
Mailing address
8165 KEVIN LN, SYLVANIA, OH 43560-1097
(419) 885-2751
(419) 824-0455
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
4078
OH
103TC0700X
Clinical Psychologist
6301010842
MI
Other
Enumeration date
06/10/2007
Last updated
07/08/2007
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