Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | OH3160976 | OH |
NPI | 1013314624 |
---|---|
Provider Name | Mrs. Erika Maxwell |
First Address | Johnstown, OH 43031-9408 |
Second Address | Johnstown, OH 43031-9408 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/11/2014 |
Last Update Date | 25/11/2014 |