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NPI Code Detail

MEDICARE: MRS. DIANE LYNNE GINGO LPCC

MEDICARE: MRS. DIANE LYNNE GINGO LPCC
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
1103K00000XBehavior AnalystE0900001OH

General Provider Information

NPI Number : 1871731653
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DIANE LYNNE GINGO LPCC
Provider Business Mailing Address
First Line : 2161 EASTWOOD AVE
Second Line :
City : AKRON
State : OH
Zip : 44305-2179
Country : US
Telephone Number : 330-798-1220
Fax Number : 330-798-1225
Provider Business Practice Location Address
First Line : 2161 EASTWOOD AVE
Second Line :
City : AKRON
State : OH
Zip : 44305-2179
Country : US
Telephone Number : 330-798-1220
Fax Number : 330-798-1225
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2009
Last Update Date : 02/02/2009

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