Individual
MRS. KATHERINE C SOUTHALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
484 WOODBINE CIR, MAYFIELD VILLAGE, OH 44143-1525
(440) 221-7392
Mailing address
484 WOODBINE CIR, MAYFIELD VILLAGE, OH 44143-1525
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-16-22792
OH
Other
Enumeration date
10/04/2016
Last updated
10/04/2016
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