Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | OH1472149 | OH |
NPI | 1043638588 |
---|---|
Provider Name | Mrs. Sarah Kinnison |
First Address | Xenia, OH 45385-1115 |
Second Address | Lebanon, OH 45036-1648 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2014 |
Last Update Date | 02/04/2014 |