Organization
NEUROBEHAVIORAL ASSOCIATES LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA SUE WILKERSON PHD (PRESIDENT)
(419) 529-9944
Entity
Organization
Contact information
Practice address
462 PARK AVE WEST, MANSFIELD, OH 44906
(419) 529-9944
(419) 529-9989
Mailing address
462 PARK AVE WEST, MANSFIELD, OH 44906
(419) 529-9944
(419) 529-9989
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2294360
—
OH
Enumeration date
12/27/2005
Last updated
01/17/2008
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