Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | E-0002077 | OH |
N | 101YS0200X | School Counselor | OH1501310 | OH |
NPI | 1124357348 |
---|---|
Provider Name | Dr. Jane A. Gardner |
First Address | Olmsted Falls, OH 44138-1530 |
Second Address | Olmsted Falls, OH 44138-1530 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/12/2009 |
Last Update Date | 14/09/2011 |