Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | KU1035971 | OH |
NPI | 1023421518 |
---|---|
Provider Name | Christine Reed |
First Address | Lorain, OH 44052-1601 |
Second Address | Lorain, OH 44052-1601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2014 |
Last Update Date | 03/06/2014 |