Healthcare Provider Details

I. General information

NPI: 1679485536
Provider Name (Legal Business Name): ALICIA DEVLIN
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W GRANVILLE RD
WORTHINGTON OH
43085-3527
US

IV. Provider business mailing address

245 CHATHAM RD
COLUMBUS OH
43214-3313
US

V. Phone/Fax

Practice location:
  • Phone: 614-450-6303
  • Fax:
Mailing address:
  • Phone: 614-940-2648
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: