Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 3495 | OH |
NPI | 1053341982 |
---|---|
Provider Name | Dr. Stuart William Bassman |
First Address | Cincinnati, OH 45244-2868 |
Second Address | Cincinnati, OH 45244-2868 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2006 |
Last Update Date | 08/07/2007 |