Healthcare Provider Details

I. General information

NPI: 1790901262
Provider Name (Legal Business Name): WILLIAM LEE CAHALAN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11497 SPRINGFIELD PIKE
CINCINNATI OH
45246-3551
US

IV. Provider business mailing address

11497 SPRINGFIELD PIKE
CINCINNATI OH
45246-3551
US

V. Phone/Fax

Practice location:
  • Phone: 513-772-9300
  • Fax: 513-772-9302
Mailing address:
  • Phone: 513-772-9300
  • Fax: 513-772-9302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1652
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: