Doctor Name: | MRS. JOANNA GREENWALT |
NPI Number: | 1003230749 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSY. S. |
License Number: | OH1250125 |
Business Practice Address: | 3805 Marlane Dr Grove City, OH - 431239224 |
Business Phone Number: | 6148013000 |
Business Fax Number: | |
Mailing Address: | 3805 Marlane Dr, GROVE CITY |
State: | OH |
Postal Code: | 431239224 |
Phone Number: | 6148013000 |
Fax Number: | |
NPI Enumeration Date: | 02/18/2014 |
NPI Last Update Date: | 02/18/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TS0200X |
License Number: | OH1250125 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | School |
Taxonomy Definition: |