Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | OH3151550 | OH |
NPI | 1043634322 |
---|---|
Provider Name | Stephanie White |
First Address | Youngstown, OH 44512-7011 |
Second Address | Youngstown, OH 44512-7011 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2014 |
Last Update Date | 07/02/2014 |