Healthcare Provider Details

I. General information

NPI: 1154790418
Provider Name (Legal Business Name): RYAN MEKOTA PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2015
Last Update Date: 01/27/2023
Certification Date: 01/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31340 SOLON RD STE 28
SOLON OH
44139-3574
US

IV. Provider business mailing address

31340 SOLON RD STE 28
SOLON OH
44139-3574
US

V. Phone/Fax

Practice location:
  • Phone: 440-363-1938
  • Fax:
Mailing address:
  • Phone: 440-363-1938
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number7348
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: