Individual
MITCHELL WAX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13535 DETROIT AVE, STE 5, LAKEWOOD, OH 44107-4625
(216) 221-6260
Mailing address
13535 DETROIT AVE, STE 5, LAKEWOOD, OH 44107-4625
(216) 221-6260
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3036
OH
Other
Enumeration date
04/20/2006
Last updated
03/15/2017
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