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General NPI Number Information
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NPI Number | 1548315625
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Entity Type | Individual
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Provider Name | MERRITT STEPHEN OLESKI PH.D.
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Gender | Male
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 11590 CENTURY BLVD SUITE 112
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City | SPRINGDALE
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State | OH
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Zip | 45246-3326
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Country | US
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Telephone | 513-671-7246
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Fax | 513-671-4786
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Provider Business Mailing Address
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Address Line | 416 ALTAVIEW CT
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City | CINCINNATI
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State | OH
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Zip | 45231-2701
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Country | US
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Telephone | 513-739-5892
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Fax |
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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 | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 3319
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License Number State | OH
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