Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 4160 | OH |
Y | 103T00000X | Psychologist | 4160 | OH |
NPI | 1013007426 |
---|---|
Provider Name | Michael J Esson |
First Address | Cleveland, OH 44122-0958 |
Second Address | Brunswick, OH 44212-2802 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0748561 | (05) | OH |