| Organization Name: | KATHY ACUS-SOUDERS, PSY.D., LLC |
| NPI Number: | 1215112214 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KATHY LYNN ACUS-SOUDERS (CLINICAL PSYCHOLOGIST) |
| Mailing Address: | 2188 Gateway Dr Fairborn |
| State: | OH US |
| Postal Code: | 453246356 |
| Phone Number: | 9378641940 |
| Fax Number: | 9378641950 |
| NPI Enumeration Date: | 01/08/2008 |
| NPI Last Update Date: | 11/26/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 5311 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |