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General NPI Number Information
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NPI Number | 1366158362
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Entity Type | Organization
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Legal Business Name | COLUMBUS OCD AND ANXIETY CLINIC
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Dates
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Enumeration Date | 01/24/2023
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Last Update Date | 01/24/2023
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Provider Practice Location Address
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Address Line | 415 CLINTON HEIGHTS AVE
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City | COLUMBUS
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State | OH
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Zip | 43202-1276
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Country | US
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Telephone | 614-638-8119
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Fax |
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Provider Business Mailing Address
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Address Line | 415 CLINTON HEIGHTS AVE
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City | COLUMBUS
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State | OH
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Zip | 43202-1276
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Country | US
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Telephone | 614-638-8119
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | DR. MATTHEW LEE FREE
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Credential | PHD
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Telephone | 614-638-8119
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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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