Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | E.0003590-SUPV | OH |
NPI | 1003042524 |
---|---|
Provider Name | Elizabeth Wolanski |
First Address | Elyria, OH 44035 |
Second Address | Elyria, OH 44035 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2009 |
Last Update Date | 10/06/2009 |