Doctor Name: | JULIMARIE MISHAK |
NPI Number: | 1033534128 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | KU1-01-0892. |
Business Practice Address: | 2700 Washington Ave Lorain, OH - 440524648 |
Business Phone Number: | 4402461020 |
Business Fax Number: | |
Mailing Address: | 2700 Washington Ave, LORAIN |
State: | OH |
Postal Code: | 440524648 |
Phone Number: | 4402461020 |
Fax Number: | |
NPI Enumeration Date: | 02/26/2014 |
NPI Last Update Date: | 02/26/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TS0200X |
License Number: | KU1-01-0892. |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | School |
Taxonomy Definition: |