MEDICARE: DR. LOUISE A. DOUCE PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC1900X	Counseling Psychologist	P-2759	OH
2	103TC1900X	Counseling Psychologist	2759	OH

General Provider Information

NPI Number	:	1619140274
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LOUISE A. DOUCE PH.D.

Provider Business Mailing Address
First Line	:	4707 BLUE CHURCH RD
Second Line	:
City	:	SUNBURY
State	:	OH
Zip	:	43074-9519
Country	:	US
Telephone Number	:	614-786-1950
Fax Number	:	614-247-8010

Provider Business Practice Location Address
First Line	:	500 W WILSON BRIDGE RD
Second Line	:	SUITE 90
City	:	WORTHINGTON
State	:	OH
Zip	:	43085-2238
Country	:	US
Telephone Number	:	614-785-1950
Fax Number	:	614-688-3440

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2008
Last Update Date	:	02/06/2013

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