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Individual

DR. MARY ANN TEITELBAUM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
5321 MEADOW LANE COURT, UNIT 5, ELYRIA, OH 44035-0601
(216) 233-1468
(440) 277-4401
Mailing address
5321 MEADOW LANE COURT, UNIT 5, ELYRIA, OH 44035-0601
(216) 233-1468
(440) 277-4401

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
4926
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000138034
ANTHEM
OH
05
0102703
OH
01
244073
VALUE OPTIONS
OH
Enumeration date
01/02/2007
Last updated
07/08/2007
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