Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | OH |
NPI | 1063962991 |
---|---|
Provider Name | Jodi Kulka |
First Address | Marysville, OH 43040-2105 |
Second Address | Marysville, OH 43040-2105 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2016 |
Last Update Date | 04/10/2016 |