Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | UA1019141 | OH |
NPI | 1023438298 |
---|---|
Provider Name | Mrs. Maureen Ray |
First Address | Mentor, OH 44060-4109 |
Second Address | Mentor, OH 44060-4109 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2014 |
Last Update Date | 25/04/2014 |