Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor | OH |
NPI | 1033742903 |
---|---|
Provider Name | Shawn Dimitri Rouse |
First Address | Cincinnati, OH 45230-3521 |
Second Address | Cincinnati, OH 45230-3521 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2020 |
Last Update Date | 19/02/2020 |