Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | COBA.00471 | OH |
NPI | 1003475476 |
---|---|
Provider Name | Katherine Winters-Hazen |
First Address | Washington, PA 15301-2630 |
Second Address | Martins Ferry, OH 43935-1544 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2019 |
Last Update Date | 10/06/2019 |