MEDICARE: JULIE ARNOLD PSY. S

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TS0200X	School Psychologist	OH3107979	OH

General Provider Information

NPI Number	:	1629435391
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE ARNOLD PSY. S

Provider Business Mailing Address
First Line	:	239 PORTAGE ST NW
Second Line	:
City	:	NORTH CANTON
State	:	OH
Zip	:	44720-2737
Country	:	US
Telephone Number	:	330-497-5665
Fax Number	:

Provider Business Practice Location Address
First Line	:	239 PORTAGE ST NW
Second Line	:
City	:	NORTH CANTON
State	:	OH
Zip	:	44720-2737
Country	:	US
Telephone Number	:	330-497-5665
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2016
Last Update Date	:	01/26/2016

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