Provider Demographics
NPI:1891320511
Name:OHIO MARRIAGE AND FAMILY THERAPY, LLC.
Entity Type:Organization
Organization Name:OHIO MARRIAGE AND FAMILY THERAPY, LLC.
Other - Org Name:THE ART OF LOVE AND INTIMACY, LLC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOMONIQUE
Authorized Official - Middle Name:LA'TOYA
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:IMFT-S
Authorized Official - Phone:614-568-1258
Mailing Address - Street 1:1491 POLARIS PKWY STE 216
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43240-2041
Mailing Address - Country:US
Mailing Address - Phone:614-568-1258
Mailing Address - Fax:
Practice Address - Street 1:1491 POLARIS PKWY STE 216
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43240-2041
Practice Address - Country:US
Practice Address - Phone:614-568-1258
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-04
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health