Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | OH3197400 | OH |
NPI | 1083086151 |
---|---|
Provider Name | Angelia Mendak |
First Address | Uniontown, OH 44685-6951 |
Second Address | Uniontown, OH 44685-6951 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2015 |
Last Update Date | 28/10/2015 |