Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist | 6869 | OH |
NPI | 1467721605 |
---|---|
Provider Name | Lynne Gauthier |
First Address | Columbus, OH 43210-1229 |
Second Address | Columbus, OH 43210-1229 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/12/2011 |
Last Update Date | 16/12/2011 |