Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | P.08160 | OH |
Y | 103TC0700X | Clinical Psychologist | P.08160 | OH |
NPI | 1003482159 |
---|---|
Provider Name | Dr. Matthew Free |
First Address | Worthington, OH 43085-2533 |
Second Address | Worthington, OH 43085-2533 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2021 |
Last Update Date | 31/05/2021 |