Healthcare Provider Details
I. General information
NPI: 1659501344
Provider Name (Legal Business Name): T. JOHN WINHUSEN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/16/2009
Last Update Date: 12/01/2023
Certification Date: 12/01/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3131 HARVEY AVE
CINCINNATI OH
45229-3000
US
IV. Provider business mailing address
3131 HARVEY AVE
CINCINNATI OH
45229-3000
US
V. Phone/Fax
- Phone: 513-585-8227
- Fax:
- Phone: 513-585-8227
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | 5568 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: