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General NPI Number Information
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NPI Number | 1942742531
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Entity Type | Organization
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Legal Business Name | METTA PSYCHOLOGY GROUP, LLC
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Dates
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Enumeration Date | 11/14/2016
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Last Update Date | 11/14/2016
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Provider Practice Location Address
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Address Line | 1560 FISHINGER RD STE 260
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City | COLUMBUS
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State | OH
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Zip | 43221-2108
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Country | US
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Telephone | 614-705-0026
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Fax |
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Provider Business Mailing Address
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Address Line | 1560 FISHINGER RD STE 260
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City | COLUMBUS
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State | OH
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Zip | 43221-2108
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | EMILY KIRBY
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Credential |
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Telephone | 614-946-1353
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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 | 6615
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License Number State | OH
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