Provider First Line Business Practice Location Address:
3830 WOODRIDGE BLVD
Provider Second Line Business Practice Location Address:
SUITE J PSYCHOTHERAPY CENTER
Provider Business Practice Location Address City Name:
FAIRFIELD
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45014
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-860-0220
Provider Business Practice Location Address Fax Number:
513-860-3123
Provider Enumeration Date:
01/24/2007