Healthcare Provider Details

I. General information

NPI: 1235226127
Provider Name (Legal Business Name): RAY MCPHAIL CROSBY PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 08/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 SUMMIT ROAD
CINCINNATI OH
45237
US

IV. Provider business mailing address

1101 SUMMIT ROAD
CINCINNATI OH
45237
US

V. Phone/Fax

Practice location:
  • Phone: 513-948-3600
  • Fax: 513-948-8631
Mailing address:
  • Phone: 513-948-3600
  • Fax: 513-948-8631

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number4659
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number4659
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: