Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | OH1-49-7460 | OH |
NPI | 1033539457 |
---|---|
Provider Name | Favia Becker |
First Address | Cleveland, OH 44114-1137 |
Second Address | Cleveland, OH 44114-1137 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2014 |
Last Update Date | 24/04/2014 |