Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | ||
N | 103TS0200X | School Psychologist | OH |
NPI | 1083039242 |
---|---|
Provider Name | Nicole Ralston |
First Address | Lorain, OH 44055-3823 |
Second Address | Lorain, OH 44055-3823 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/02/2014 |
Last Update Date | 25/02/2014 |