Healthcare Provider Details

I. General information

NPI: 1790694933
Provider Name (Legal Business Name): MARY ELIZABETH SILVERS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 STATE ROUTE 131
MILFORD OH
45150-1825
US

IV. Provider business mailing address

900 STATE ROUTE 131
MILFORD OH
45150-1825
US

V. Phone/Fax

Practice location:
  • Phone: 513-831-0460
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberLSP.02570
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: