Individual
CARLA CODANI HISATUGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
106 STOVER DR, DELAWARE, OH 43015-8601
(740) 417-9265
Mailing address
106 STOVER DR, DELAWARE, OH 43015-8601
(740) 417-9265
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
02/18/2020
Last updated
11/04/2022
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