Provider Demographics
NPI:1972904894
Name:INCILER, MUJGAN (PHD)
Entity type:Individual
Prefix:DR
First Name:MUJGAN
Middle Name:
Last Name:INCILER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5841 HAMILTON MASON RD
Mailing Address - Street 2:
Mailing Address - City:LIBERTY TWP
Mailing Address - State:OH
Mailing Address - Zip Code:45011-9723
Mailing Address - Country:US
Mailing Address - Phone:513-932-3388
Mailing Address - Fax:
Practice Address - Street 1:5787 STATE ROUTE 63
Practice Address - Street 2:C/O WCI
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036
Practice Address - Country:US
Practice Address - Phone:513-932-3388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-10
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5262103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical