Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 1002092 | OH |
NPI | 1023497039 |
---|---|
Provider Name | Vicki Williamson |
First Address | Xenia, OH 45385-2212 |
Second Address | Bellbrook, OH 45305-8750 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2015 |
Last Update Date | 22/05/2015 |