Doctor Name: | JAKE PROTIVNAK |
NPI Number: | 1689889156 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PC |
License Number: | C7727 |
Business Practice Address: | 3920 Lovers Ln Ravenna, OH - 442664200 |
Business Phone Number: | 3306731347 |
Business Fax Number: | 3306783677 |
Mailing Address: | 5982 Rhodes Rd, KENT |
State: | OH |
Postal Code: | 442404128 |
Phone Number: | 3306731347 |
Fax Number: | 3306783677 |
NPI Enumeration Date: | 05/10/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | C7727 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |