Individual
MRS. GRETCHEN WAKIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
585 RIVERSIDE DR, PAINESVILLE, OH 44077-5323
(440) 357-6171
(440) 352-1257
Mailing address
585 RIVERSIDE DR, PAINESVILLE, OH 44077-5323
(440) 357-6171
(440) 352-1257
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
20870491
OH
Other
Enumeration date
08/13/2014
Last updated
08/13/2014
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