Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 3608 | OH |
N | 103TC0700X | Clinical Psychologist | 3608 | OH |
N | 103G00000X | Clinical Psychologist | 3608 | OH |
N | 103TC0700X | Clinical Psychologist | 3608 | OH |
N | 103TH0100X | Health Service | 3608 | OH |
NPI | 1548349798 |
---|---|
Provider Name | Kevin Huban |
First Address | Dayton, OH 45419-3243 |
Second Address | Dayton, OH 45409-2722 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2006 |
Last Update Date | 08/07/2007 |