Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 2964 | OH |
NPI | 1003844739 |
---|---|
Provider Name | Dr. Dick A. Genardi |
First Address | Centerville, OH 45459-4252 |
Second Address | Centerville, OH 45459-4252 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 08/04/2013 |