Organization
PATH NEUROPSYCHOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAWNA JACOB PHD (CLINICAL PSYCHOLOGIST)
(513) 813-5327
Entity
Organization
Contact information
Practice address
2812 MACK RD, FAIRFIELD, OH 45014-5130
(513) 429-9886
Mailing address
2812 MACK RD, FAIRFIELD, OH 45014-5130
(513) 813-5327
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
—
—
Other
Enumeration date
01/18/2023
Last updated
03/22/2023
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