Healthcare Provider Details

I. General information

NPI: 1922065697
Provider Name (Legal Business Name): EVE P WHITMORE PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: EVE P FISHER WHITMORE PHD

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 01/08/2020
Certification Date: 01/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4833 DARROW RD STE 101
STOW OH
44224-1411
US

IV. Provider business mailing address

4833 DARROW RD STE 101
STOW OH
44224-1411
US

V. Phone/Fax

Practice location:
  • Phone: 330-650-5338
  • Fax: 330-342-3837
Mailing address:
  • Phone: 330-650-5338
  • Fax: 330-342-3837

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number4305
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: