Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | E.0500398 | OH |
NPI | 1003134230 |
---|---|
Provider Name | Ms. Katherine Anne Risinger |
First Address | Detroit, MI 48278-1625 |
Second Address | Columbus, OH 43205-2140 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2010 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2846675 | (05) | OH |