Individual
JEAN B BAGAZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
242 CARROWMOORE DR, PICKERINGTON, OH 43147-3511
(515) 380-5393
Mailing address
242 CARROWMOORE DR, PICKERINGTON, OH 43147-3511
(515) 380-5393
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
—
OH
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
—
OH
Other
Enumeration date
09/04/2023
Last updated
09/04/2023
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