Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | C. 0008153 | OH |
NPI | 1003032756 |
---|---|
Provider Name | Carol A Dikovitsky |
First Address | Highland Hts, OH 44143-3015 |
Second Address | Highland Hts, OH 44143-3015 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2007 |
Last Update Date | 08/07/2007 |