Organization
SOUTHWESTERN OHIO BEHAVIORAL HEALTH,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBERLY SHAFFER TATE PSY.D (OWNER-CLINICAL PSYCHOLOGIST)
(937) 435-8864
Entity
Organization
Contact information
Practice address
35 IRONGATE PARK DR, CENTERVILLE, OH 45459-4616
(937) 435-8864
(937) 435-8264
Mailing address
PO BOX 41158, DAYTON, OH 45441-0158
(937) 435-8864
(937) 435-8264
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
4664
OH
Other
Enumeration date
10/11/2006
Last updated
06/29/2011
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