Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | I.0010286.SUPV | OH |
NPI | 1003119942 |
---|---|
Provider Name | Mrs. Kerry Katz |
First Address | Cleveland, OH 44120-2746 |
Second Address | Shaker Heights, OH 44118-4819 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2010 |
Last Update Date | 15/12/2010 |