Individual
DR. TY BRUMBACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
3380 ERIE AVE STE 202, CINCINNATI, OH 45208-1626
(513) 400-5905
Mailing address
7060 JEANNIE AVE, CINCINNATI, OH 45230-4031
(859) 572-1484
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
P.08007
OH
103TA0400X
Addiction (Substance Use Disorder) Psychologist
P.08007
OH
103TB0200X
Cognitive & Behavioral Psychologist
P.08007
OH
103TC0700X
Clinical Psychologist
Primary
P.08007
OH
103TH0100X
Health Service Psychologist
P.08007
OH
Other
Enumeration date
04/09/2020
Last updated
04/09/2020
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