Individual
MRS. KATRINA JOHNSON LEVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CAS, NCSP
Contact information
Practice address
149 N MAIN ST, FAIRPORT, NY 14450-1434
(585) 377-2230
Mailing address
149 N MAIN ST, FAIRPORT, NY 14450-1434
(585) 377-2230
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
1215355
NY
Other
Enumeration date
07/31/2008
Last updated
07/31/2008
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