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:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 103G00000X | Behavioral Health & Social Service Providers Clinical Neuropsychologist | OH | 4060 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
2013136 | OH | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin