Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1817449 | OH |
N | 225CA2400X | Assistive Technology Practitioner | 1817449 | OH |
N | 225CA2500X | Assistive Technology Supplier | 1817449 | OH |
NPI | 1487928628 |
---|---|
Provider Name | Dr. Aries Nichelle Cobb |
First Address | University Heights, OH 44118-2617 |
Second Address | University Heights, OH 44118-2617 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2012 |
Last Update Date | 27/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0059044 | (05) | OH |