Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | P07979 | OH |
Y | 103T00000X | Psychologist | P07979 | OH |
N | 225C00000X | Rehabilitation Counselor | 2012888 | CA |
NPI | 1265952105 |
---|---|
Provider Name | Dr. Maximilian Isarapab Tokarsky |
First Address | Dayton, OH 45404-1815 |
Second Address | Dayton, OH 45404-1815 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2017 |
Last Update Date | 22/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0384058 | (05) | OH |