Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | OH1250125 | OH |
NPI | 1003230749 |
---|---|
Provider Name | Mrs. Joanna Greenwalt |
First Address | Grove City, OH 43123-9224 |
Second Address | Grove City, OH 43123-9224 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/02/2014 |
Last Update Date | 18/02/2014 |