Individual
CAROLYN E IEVERS-LANDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-7700
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
5331
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000196535
ANTHEM
OH
05
—
2238608
—
OH
01
—
341438215
AETNA
OH
Enumeration date
07/21/2006
Last updated
09/11/2012
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