Provider Demographics
NPI:1861894438
Name:PAJKA, RALPH (ED S NCSP)
Entity type:Individual
Prefix:
First Name:RALPH
Middle Name:
Last Name:PAJKA
Suffix:
Gender:M
Credentials:ED S NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6625 BENNINGTON DR
Mailing Address - Street 2:
Mailing Address - City:PARMA HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-4004
Mailing Address - Country:US
Mailing Address - Phone:440-888-2388
Mailing Address - Fax:
Practice Address - Street 1:6625 BENNINGTON DR
Practice Address - Street 2:
Practice Address - City:PARMA HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-4004
Practice Address - Country:US
Practice Address - Phone:440-888-2388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-25
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP102103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSP102OtherOHIO BOARD OF PSYCHOLOGY