Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 3634 | OH |
NPI | 1033121850 |
---|---|
Provider Name | Patricia Ann Child |
First Address | Columbus, OH 43221-1500 |
Second Address | Columbus, OH 43221-1500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2006 |
Last Update Date | 08/07/2007 |