Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | E2613 | |
N | 103TP2701X | Group Psychotherapist |
NPI | 1194836809 |
---|---|
Provider Name | Janice Kay Hershberger |
First Address | Ashland, OH 44805 |
Second Address | Ashland, OH 44805 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000179476 | ANTHEM (01) |