MEDICARE: REDMOND AND ASSOCIATES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	3455	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023276839
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REDMOND AND ASSOCIATES

Provider Business Mailing Address
First Line	:	265 W MAIN ST
Second Line	:	SUITE 102
City	:	KENT
State	:	OH
Zip	:	44240-2461
Country	:	US
Telephone Number	:	330-678-9210
Fax Number	:	330-676-1199

Provider Business Practice Location Address
First Line	:	265 W MAIN ST
Second Line	:	SUITE 102
City	:	KENT
State	:	OH
Zip	:	44240-2461
Country	:	US
Telephone Number	:	330-678-9210
Fax Number	:	330-676-1199

Authorized Official
Title or Position	:	PSYCHOLOGIST
Name	:	DR. CHAREL LEE KHOL
Credential	:	PH.D.
Telephone Number	:	330-678-9210

Provider Enumeration Date	:	05/29/2008
Last Update Date	:	05/29/2008

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Directions to “REDMOND AND ASSOCIATES ” Practice Location

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