Wyatt, Elizabeth Blair
Wyatt, Elizabeth Blair is an individual health care provider with primary practice located at 8039 Broadmoor Rd #15, Mentor OH 44060. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Wyatt, Elizabeth Blair can be contacted via phone (440) 269-1500.Contact Information
Primary practice address
8039 Broadmoor Rd #15
Mentor OH 44060
Phone: (440) 269-1500
Fax: (440) 269-8545
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 4508 | Ohio |
Profile Details
| NPI number | 1285744276 |
|---|---|
| LBN Legal business name | Wyatt, Elizabeth Blair |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 30th, 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 | 1285744276 | NPPES |
| Ohio | MEDICAID | 2065732 |
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