Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | CI1000131 | OH |
NPI | 1013469485 |
---|---|
Provider Name | Dr. Melinda Mastman |
First Address | Cincinnati, OH 45231-3183 |
Second Address | Cincinnati, OH 45231-3183 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2016 |
Last Update Date | 01/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CI1000131 | SCHOOL PSYCHOLOGIST (01) | OH |