Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist |
NPI | 1003230087 |
---|---|
Provider Name | Sarah Eickholt |
First Address | Perrysburg, OH 43551-7429 |
Second Address | Toledo, OH 43613-5109 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2014 |
Last Update Date | 11/02/2014 |