Individual
CORINNE GIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D, BCBA-D, COBA
Contact information
Practice address
30559 PINETREE RD STE 211, PEPPER PIKE, OH 44124-5919
(216) 245-2404
Mailing address
30559 PINETREE RD STE 211, PEPPER PIKE, OH 44124-5919
(216) 245-2404
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
COBA.97
OH
103TS0200X
School Psychologist
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
374264
—
OH
Enumeration date
02/03/2014
Last updated
10/21/2024
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