Individual
ELISE MINICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SCHOOL PSYCHOLOGIST
Contact information
Practice address
9769D NOBLE LN, VAN WERT, OH 45891-9157
(419) 605-8287
Mailing address
9769D NOBLE LN, VAN WERT, OH 45891-9157
(419) 605-8287
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
20933633
OH
Other
Enumeration date
08/25/2014
Last updated
08/25/2014
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