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General NPI Number Information
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NPI Number | 1265689806
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Entity Type | Individual
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Provider Name | IVY F TSO PH.D.
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Gender | Female
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Dates
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Enumeration Date | 08/26/2008
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Last Update Date | 07/09/2024
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Provider Practice Location Address
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Address Line | 3650 OLENTANGY RIVER RD FL 3
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City | COLUMBUS
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State | OH
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Zip | 43214-3464
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Country | US
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Telephone | 614-293-9600
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Fax | 614-293-1456
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Provider Business Mailing Address
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Address Line | 700 ACKERMAN RD STE 2120
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City | COLUMBUS
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State | OH
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Zip | 43202-1559
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Country | US
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Telephone | 614-293-9600
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Fax | 614-293-1456
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6301015248
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6301015248
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License Number State | MI
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