Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | RF921520 | OH |
NPI | 1083008692 |
---|---|
Provider Name | Ms. Michelle Metz |
First Address | Dayton, OH 45439-1521 |
Second Address | Dayton, OH 45439-1521 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2015 |
Last Update Date | 20/03/2015 |