Healthcare Provider Details

I. General information

NPI: 1255359634
Provider Name (Legal Business Name): MARIAN B. PATTERSON PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 EUCLID AVE
CLEVELAND OH
44106-1716
US

IV. Provider business mailing address

3605 WARRENSVILLE CENTER RD
SHAKER HEIGHTS OH
44122-5203
US

V. Phone/Fax

Practice location:
  • Phone: 216-844-3192
  • Fax:
Mailing address:
  • Phone: 440-684-5979
  • Fax: 440-684-5952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number1610
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: