Organization
BOWLING GREEN STATE UNIVERSITY
Active
Other names
Bowling Green State University
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA K KELSO (ADMINISTRATIVE ASSISTANT)
(419) 372-2540
Entity
Organization
Contact information
Practice address
PSYCHOLOGICAL SERVICES CENTER, SUITE 300 PSYCHOLOGY DEPT. BOWLING GREEN STATE UNIV, BOWLING GREEN, OH 43403
(419) 372-2540
(419) 372-2533
Mailing address
PSYCHOLOGICAL SERVICES CENTER, SUITE 300 PSYCHOLOGY DEPT. BOWLING GREEN STATE UNIV, BOWLING GREEN, OH 43403-0001
(419) 372-2540
(419) 372-2533
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0747240
—
OH
Enumeration date
04/28/2006
Last updated
06/18/2018
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