Doctor Name: | DR. TIMOTHY CALLAHAN |
NPI Number: | 1861850026 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PSY.D. |
License Number: | 4411 |
Business Practice Address: | 360 E Enon Rd Yellow Springs, OH - 453871415 |
Business Phone Number: | 9377671303 |
Business Fax Number: | 9377671025 |
Mailing Address: | 360 E Enon Rd, YELLOW SPRINGS |
State: | OH |
Postal Code: | 453871415 |
Phone Number: | 9377671303 |
Fax Number: | 9377671025 |
NPI Enumeration Date: | 02/03/2016 |
NPI Last Update Date: | 02/03/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 4411 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |