Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist |
NPI | 1013380237 |
---|---|
Provider Name | Christine Masulovich |
First Address | Fairview Park, OH 44126-2105 |
Second Address | Fairview Park, OH 44126-2105 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2015 |
Last Update Date | 10/11/2015 |