Individual
THOMAS PACKARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
5450 FAR HILLS AVE, SUITE 110, KETTERING, OH 45429-2386
(937) 436-5361
(937) 436-1468
Mailing address
5450 FAR HILLS AVE, SUITE 110, KETTERING, OH 45429-2386
(937) 436-5361
(937) 436-1468
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
3946
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0883165
—
OH
Enumeration date
06/07/2006
Last updated
07/09/2007
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