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General NPI Number Information
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NPI Number | 1003526708
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Entity Type | Organization
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Legal Business Name | DAYTON THERAPY AND ASSESSMENT PRACTICE, LLC
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Dates
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Enumeration Date | 12/05/2022
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Last Update Date | 12/05/2022
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Provider Practice Location Address
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Address Line | 70 BIRCH ALLEY SUITE 240, #3912
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City | BEAVERCREEK
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State | OH
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Zip | 45440
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Country | US
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Telephone | 937-499-0589
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 397
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City | FRANKLIN
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State | OH
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Zip | 45005-0397
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Country | US
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Telephone | 937-499-0589
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSHUA WILLIAM SHUMAN
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Credential | PSYD
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Telephone | 937-499-0589
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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