Individual
DR. SAMUEL THOMAS GONTKOVSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
455 SHAWNEE LN, CHILLICOTHE, OH 45601-4145
(740) 779-4888
(740) 779-4898
Mailing address
455 SHAWNEE LN, CHILLICOTHE, OH 45601-4145
(740) 779-4888
(740) 779-4898
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
3446-57
WI
103TC0700X
Clinical Psychologist
42692
MS
103TC0700X
Clinical Psychologist
723
NE
103TC0700X
Clinical Psychologist
Primary
7285
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0108112
—
OH
Enumeration date
12/04/2006
Last updated
12/14/2022
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