Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | ||
Y | 103T00000X | Psychologist | ||
N | 103TC1900X | Counseling Psychologist | ||
N | 103TC2200X | Clinical Child & Adolescent Psychologist | ||
N | 103TM1800X | Intellectual & Developmental Disabilities |
NPI | 1124221296 |
---|---|
Provider Name | Cynthia A. Yamokoski |
First Address | Kent, OH 44240-4312 |
Second Address | Kent, OH 44240-4312 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2007 |
Last Update Date | 24/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10024 | (05) | OH |
10034 | (05) | OH |