Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 1500402 | OH |
NPI | 1003276288 |
---|---|
Provider Name | Jaime Anne Mariage |
First Address | Bay Village, OH 44140-2502 |
Second Address | Cleveland, OH 44102-1645 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2016 |
Last Update Date | 01/03/2016 |