Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP1600X | Pastoral Counselor | ||
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist |
NPI | 1093272221 |
---|---|
Provider Name | Elaine Mclean |
First Address | Dayton, OH 45402-6216 |
Second Address | Dayton, OH 45402-6216 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2019 |
Last Update Date | 24/02/2019 |