Organization
VITAL MINDS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY ANN ICKES PSYD (PSYCHOLOGIST/OWNER)
(513) 268-8575
Entity
Organization
Contact information
Practice address
9122 MONTGOMERY RD STE 18, CINCINNATI, OH 45242-7746
(513) 268-8575
(512) 268-2052
Mailing address
9292 STEEPLECHASE DR, CINCINNATI, OH 45242-4637
(513) 268-8575
(513) 268-2052
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
10/05/2023
Last updated
10/05/2023
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