Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist |
NPI | 1013332113 |
---|---|
Provider Name | Shannon Ciriello |
First Address | Cleveland, OH 44105-2846 |
Second Address | Cleveland, OH 44105-2846 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2014 |
Last Update Date | 26/02/2014 |