Healthcare Provider Details

I. General information

NPI: 1003746975
Provider Name (Legal Business Name): MARY CATHERINE DROP YENTSCH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6097 JOHNSTOWN UTICA RD
JOHNSTOWN OH
43031-9408
US

IV. Provider business mailing address

555 BUENA PARK DR
DELAWARE OH
43015-3257
US

V. Phone/Fax

Practice location:
  • Phone: 740-967-6631
  • Fax:
Mailing address:
  • Phone: 717-903-0997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberLSP.01943
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: