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General NPI Number Information
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NPI Number | 1750416509
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Entity Type | Organization
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Legal Business Name | BEHAVIOR MEDICINE ASSOCIATES, INC.
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 05/21/2020
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Provider Practice Location Address
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Address Line | 3806 N HIGH ST
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City | COLUMBUS
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State | OH
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Zip | 43214-3527
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Country | US
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Telephone | 614-261-1216
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Fax | 614-263-7070
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Provider Business Mailing Address
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Address Line | 3806 N HIGH ST
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City | COLUMBUS
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State | OH
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Zip | 43214-3527
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Country | US
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Telephone | 614-261-1216
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Fax | 614-263-7070
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Authorized Official
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Title or Position | CONTROLLER
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Name | MR. RICHARD C. KRIGER
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Credential |
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Telephone | 614-261-1216
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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 | 1180
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License Number State | OH
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