Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 4928 | OH |
NPI | 1003944224 |
---|---|
Provider Name | Deborah Walsh |
First Address | Ravenna, OH 44266-3177 |
Second Address | Ravenna, OH 44266-3177 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2007 |
Last Update Date | 08/07/2007 |