Provider Demographics
NPI:1003526708
Name:DAYTON THERAPY AND ASSESSMENT PRACTICE, LLC
Entity Type:Organization
Organization Name:DAYTON THERAPY AND ASSESSMENT PRACTICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:SHUMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:937-499-0589
Mailing Address - Street 1:PO BOX 397
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:OH
Mailing Address - Zip Code:45005-0397
Mailing Address - Country:US
Mailing Address - Phone:937-499-0589
Mailing Address - Fax:
Practice Address - Street 1:70 BIRCH ALLEY
Practice Address - Street 2:SUITE 240, #3912
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45440
Practice Address - Country:US
Practice Address - Phone:937-499-0589
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty