Healthcare Provider Details

I. General information

NPI: 1154231561
Provider Name (Legal Business Name): EVAN SALTZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

400 W SYCAMORE ST
OXFORD OH
45056-1168
US

IV. Provider business mailing address

131 W CHESTNUT ST
OXFORD OH
45056-2619
US

V. Phone/Fax

Practice location:
  • Phone: 513-273-3500
  • Fax:
Mailing address:
  • Phone: 513-273-3500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberLSP.03298
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: