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NPI Code Detail

MEDICARE: DR. MINA M SANTORSOLA LOCKEY PSY.D.

MEDICARE:  DR. MINA M SANTORSOLA LOCKEY  PSY.D.
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
1103T00000XPsychologist
2103T00000XPsychologist2127OR
3103TC0700XClinical Psychologist7269OH

General Provider Information

NPI Number : 1699965996
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MINA M SANTORSOLA LOCKEY PSY.D.
Provider Business Mailing Address
First Line : 4760 E GALBRAITH RD STE 210
Second Line :
City : CINCINNATI
State : OH
Zip : 45236-6704
Country : US
Telephone Number : 513-686-4800
Fax Number :
Provider Business Practice Location Address
First Line : 4760 E GALBRAITH RD STE 210
Second Line :
City : CINCINNATI
State : OH
Zip : 45236-6704
Country : US
Telephone Number : 513-686-4800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2007
Last Update Date : 03/23/2015

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Directions to “ DR. MINA M SANTORSOLA LOCKEY PSY.D.” Practice Location

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