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General NPI Number Information
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NPI Number | 1497028005
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Entity Type | Organization
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Legal Business Name | PSI ASSOCIATES
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Dates
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Enumeration Date | 02/13/2012
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Last Update Date | 02/13/2012
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Provider Practice Location Address
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Address Line | 2112 CASE PARKWAY SOUTH #10
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City | TWINSBURG
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State | OH
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Zip | 44087
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Country | US
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Telephone | 330-425-8474
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Fax | 330-425-2905
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Provider Business Mailing Address
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Address Line | PO BOX 468 2112 CASE PARKWAY SOUTH #10
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City | TWINSBURG
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State | OH
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Zip | 44087
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Country | US
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Telephone | 330-425-8474
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Fax | 330-425-2905
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Authorized Official
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Title or Position | PRESIDENT
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Name | STEVEN L ROSENBERG
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Credential | PHD
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Telephone | 330-425-8474
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 2952
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License Number State | OH
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