Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | E1901207 | OH |
N | 101YS0200X | School Counselor | C1200473 | OH |
NPI | 1245755545 |
---|---|
Provider Name | Lyniece Spyker |
First Address | Detroit, MI 48278-1625 |
Second Address | Columbus, OH 43215-5384 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2017 |
Last Update Date | 13/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1473276 | (05) | OH |