Organization
MIND BODY SPIRIT CENTER FOR HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATHIE C SHOCKLEY PHD (PSYCHOLOGIST)
(614) 457-9797
Entity
Organization
Contact information
Practice address
4701 OLENTANGY RIVER RD, SUITE 200, COLUMBUS, OH 43214-1950
(614) 457-9797
(614) 442-8208
Mailing address
4701 OLENTANGY RIVER RD, SUITE 200, COLUMBUS, OH 43214-1950
(614) 457-9797
(614) 442-8208
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
4139
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0308803
—
OH
Enumeration date
07/01/2011
Last updated
07/01/2011
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