Healthcare Provider Details

I. General information

NPI: 1619140274
Provider Name (Legal Business Name): LOUISE A. DOUCE PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2008
Last Update Date: 02/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W WILSON BRIDGE RD SUITE 90
WORTHINGTON OH
43085-2238
US

IV. Provider business mailing address

4707 BLUE CHURCH RD
SUNBURY OH
43074-9519
US

V. Phone/Fax

Practice location:
  • Phone: 614-785-1950
  • Fax: 614-688-3440
Mailing address:
  • Phone: 614-786-1950
  • Fax: 614-247-8010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberP-2759
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number2759
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: