Individual
FARRAH JACQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
225 CALHOUN ST, SUITE 280, CINCINNATI, OH 45219-1528
(513) 556-5594
Mailing address
DEPARTMENT OF PSYCHOLOGY, PO BOX 2120376, CINCINNATI, OH 45221-0376
(513) 556-5124
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6542
OH
Other
Enumeration date
03/14/2014
Last updated
03/14/2014
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