Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | OH1517022 | OH |
NPI | 1003286089 |
---|---|
Provider Name | Stephanie Elie |
First Address | Zanesville, OH 43701-3791 |
Second Address | Zanesville, OH 43701-3791 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2015 |
Last Update Date | 02/10/2015 |