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General NPI Number Information
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NPI Number | 1386063717
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Entity Type | Individual
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Provider Name | KATHRYN JANE PEDRO P.C.C.
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Gender | Female
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Dates
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Enumeration Date | 04/14/2014
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Last Update Date | 06/27/2019
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Provider Practice Location Address
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Address Line | 5858 N HIGH ST STE C
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City | WORTHINGTON
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State | OH
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Zip | 43085-4183
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Country | US
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Telephone | 614-842-2121
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Fax |
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Provider Business Mailing Address
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Address Line | 5858 N HIGH ST STE C
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City | WORTHINGTON
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State | OH
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Zip | 43085-4183
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Country | US
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Telephone | 614-738-3104
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | E1000215
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License Number State | OH
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