Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | E2114 | OH |
N | 101YS0200X | School Counselor | OH1239462 | OH |
NPI | 1194136879 |
---|---|
Provider Name | Kimberly Go |
First Address | Norwalk, OH 44857-1925 |
Second Address | New London, OH 44851-9262 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2014 |
Last Update Date | 15/05/2014 |