Organization
WESTERN OHIO PSYCHOLOGICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE ALLEN (PSYD)
(973) 638-5210
Entity
Organization
Contact information
Practice address
110 E POPLAR ST, STE. 7, SIDNEY, OH 45365-2985
(937) 638-5210
Mailing address
110 E POPLAR ST, STE. 7, SIDNEY, OH 45365-2985
(937) 638-5210
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
7027
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
61000064
—
OH
Enumeration date
06/13/2016
Last updated
08/17/2016
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