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KENNETH PATE BAIN PHD

Clinical Neuropsychologist

Columbus, Ohio

Provider NPI: 1902894157

Provider Information:
 KENNETH PATE BAIN PHD
Gender: M
Not Sole Proprietor

Practice Location:
3724 OLENTANGY RIVER RD SUITE A COLUMBUS, OH 43214 US
Tel: 614-566-1749  Fax: 614-566-1916

Business Mailing Address:
5350 FRANTZ RD  DUBLIN, OH 43016 US
Tel: --  Fax: --

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
OH4060

Other Provider Identifiers:

IssuerNumberStateType
2013136OH05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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