Organization
GARY D. ACKERLEY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY D. ACKERLEY PH.D.,ABPP (PRESIDENT)
(937) 640-1432
Entity
Organization
Contact information
Practice address
305 E STROOP RD, DAYTON, OH 45429-2827
(937) 640-1432
(937) 294-3320
Mailing address
305 E STROOP RD, DAYTON, OH 45429-2827
(937) 640-1432
(937) 294-3320
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2853
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000328814
ANTHEM BCBS
OH
01
—
6159301
UNITED HEALTH CARE
OH
Enumeration date
04/07/2007
Last updated
08/22/2020
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