Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | OH3151555 | OH |
NPI | 1073923215 |
---|---|
Provider Name | Michelle O'donnell |
First Address | University Heights, OH 44118-3301 |
Second Address | University Heights, OH 44118-3301 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2014 |
Last Update Date | 28/04/2014 |