Individual
DR. ELLEN KAY DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.H.D
Contact information
Practice address
785 E BROAD ST, COLUMBUS, OH 43205-1013
(614) 621-3673
(614) 621-9508
Mailing address
785 E BROAD ST, COLUMBUS, OH 43205-1013
(614) 621-3673
(614) 621-9508
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3997
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DOCP06131
—
OH
Enumeration date
04/03/2007
Last updated
07/08/2007
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