Provider Demographics
NPI:1346334810
Name:MCINTIRE, DONALD HARRY (PHD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:HARRY
Last Name:MCINTIRE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 EXECUTIVE DR
Mailing Address - Street 2:STE 201
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-6302
Mailing Address - Country:US
Mailing Address - Phone:419-562-2000
Mailing Address - Fax:419-562-1296
Practice Address - Street 1:125 EXECUTIVE DR
Practice Address - Street 2:SUITE 201
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-6285
Practice Address - Country:US
Practice Address - Phone:740-387-3087
Practice Address - Fax:740-382-5034
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4545103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical