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General NPI Number Information
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NPI Number | 1194122549
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Entity Type | Individual
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Provider Name | CHRISTINA GULLEY SCHOOL PSYCHOLOGIST
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Gender | Female
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Dates
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Enumeration Date | 12/01/2014
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Last Update Date | 12/01/2014
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Provider Practice Location Address
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Address Line | 2302 WADE AVE
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City | ASHTABULA
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State | OH
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Zip | 44004-9435
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Country | US
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Telephone | 440-992-1240
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Fax | 441-992-1242
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Provider Business Mailing Address
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Address Line | 2302 WADE AVENUE
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City | ASHTABULA
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State | OH
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Zip | 44004
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Country | US
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Telephone | 440-992-1240
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Fax | 441-992-1242
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 20654683
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License Number State | OH
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