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Individual

DR. KATHLEEN S FERGUSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
4450 CARVER WOODS DR, CINCINNATI, OH 45242-5527
(513) 984-9940
(513) 984-9858
Mailing address
4450 CARVER WOODS DR, CINCINNATI, OH 45242-5527
(513) 984-9940
(513) 984-9858

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
5943
OH
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
5943
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11645952
CAQH
OH
05
2570927
OH
Enumeration date
08/15/2005
Last updated
04/15/2009
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