Ellenwood, Audrey Erlene
Ellenwood, Audrey Erlene is an sole proprietor health care provider with primary practice located at 6400 Monroe St Suite E, Sylvania OH 43560-1453. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Ellenwood, Audrey Erlene can be contacted via phone (419) 885-4121.Contact Information
Primary practice address
6400 Monroe St Suite E
Sylvania OH 43560-1453
Phone: (419) 885-4121
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 3998 | Ohio |
Profile Details
| NPI number | 1265547681 |
|---|---|
| LBN Legal business name | Ellenwood, Audrey Erlene |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 19th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1265547681 | NPPES |
| Ohio | MEDICAID | 023158 |
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