NPI | 1598806945 |
---|---|
Former Name | MARY JANE KOCIAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: OH 5701) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OH 5701) |
Enumeration Date | 2007-02-09 |
Last Update Date | 2020-04-29 |