=====================================================
General NPI Number Information
=====================================================
NPI Number | 1316349673
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CRISTEN MARIE BATES-SCHON M.ED.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/18/2014
-----------------------------------------------------
Last Update Date | 09/18/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1250 SANFORD ST
-----------------------------------------------------
City | VERMILION
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44089-1577
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 440-204-1701
-----------------------------------------------------
Fax | 440-204-1781
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1250 SANFORD ST
-----------------------------------------------------
City | VERMILION
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44089-1577
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 440-204-1701
-----------------------------------------------------
Fax | 440-204-1781
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TS0200X
-----------------------------------------------------
Taxonomy Name | School Psychologist
-----------------------------------------------------
License Number | AU1006869
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------