Organization
CITIZENS ACADEMY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUG MANGEN (TREASURER)
(216) 456-2086
Entity
Organization
Contact information
Practice address
3615 SUPERIOR AVENUE, CLEVELAND, OH 44114
(216) 456-2086
Mailing address
3615 SUPERIOR AVENUE, CLEVELAND, OH 44114
(216) 456-2086
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
—
—
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Enumeration date
07/16/2013
Last updated
10/01/2019
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