Healthcare Provider Details

I. General information

NPI: 1043760408
Provider Name (Legal Business Name): CHARLOTTE LEHTO ED. S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2016
Last Update Date: 10/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6620 SANBORN RD
ASHTABULA OH
44004-9552
US

IV. Provider business mailing address

6620 SANBORN RD
ASHTABULA OH
44004-9552
US

V. Phone/Fax

Practice location:
  • Phone: 440-993-2618
  • Fax: 440-993-2647
Mailing address:
  • Phone: 440-993-2618
  • Fax: 440-993-2647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberP-SS-S KU1-00-8873
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: