Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 4835 | OH |
N | 103TS0200X | School Psychologist | 4835 | OH |
NPI | 1114087848 |
---|---|
Provider Name | Dr. Kathryn R. Shroder |
First Address | Warren, OH 44484-6705 |
Second Address | Warren, OH 44484-6705 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/12/2006 |
Last Update Date | 08/07/2007 |