Healthcare Provider Details

I. General information

NPI: 1033024252
Provider Name (Legal Business Name): CATLYN WALTEMIRE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 W NATIONAL RD
ENGLEWOOD OH
45315-9508
US

IV. Provider business mailing address

1150 W NATIONAL RD
ENGLEWOOD OH
45315-9508
US

V. Phone/Fax

Practice location:
  • Phone: 999-999-9999
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberLSP.00118
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: