Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | OT10000588 | OH |
Y | 103T00000X | Psychologist | OT10000588 | OH |
NPI | 1013305788 |
---|---|
Provider Name | Cheryl Lykins |
First Address | Fairfield, OH 45014-3006 |
Second Address | Fairfield, OH 45014-3006 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2015 |
Last Update Date | 05/01/2015 |