Elizabeth B Wyatt Phd INC
Psychologist, Clinical in Mentor, OH. Organization (NPI-2).
NPI number1407176605
StatusActive
Last updated in NPPESJun 10, 2010
Details
- NPI
- 1407176605
- Entity type
- Organization (NPI-2)
- Legal business name
- Elizabeth B Wyatt Phd INC
- Organization subpart
- No
- Enumeration date
- Jun 10, 2010
- Last updated
- Jun 10, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | 4508 | OH | Yes |
Practice location
8039 Broadmoor RdSuite 15
Mentor, OH 44060-7577
Phone 440-269-1500 · Fax 440-269-8545
Mailing address
8039 Broadmoor RdSuite 15
Mentor, OH 44060-7577
Phone 440-269-1500 · Fax 440-269-8545
Authorized official
Elizabeth Blair Wyatt
President
4402691500
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