Individual
GERARD A BANEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
5571
OH
103TC2200X
Clinical Child & Adolescent Psychologist
5571
OH
103TH0004X
Health Psychologist
5571
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2167319
—
OH
Enumeration date
01/25/2007
Last updated
11/18/2021
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