Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist |
NPI | 1558646406 |
---|---|
Provider Name | Dr. Sara Elizabeth Walters-Bugbee |
First Address | Cleveland, OH 44106-1702 |
Second Address | Cleveland, OH 44106-1702 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2011 |
Last Update Date | 11/10/2011 |