Healthcare Provider Details

I. General information

NPI: 1326094178
Provider Name (Legal Business Name): VIRGINIA EILEEN STRENGER PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VIRGINIA E STRENGER PHD

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 02/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30432 EUCLID AVE STE 221
WICKLIFFE OH
44092-1577
US

IV. Provider business mailing address

30432 EUCLID AVE STE 221
WICKLIFFE OH
44092-1577
US

V. Phone/Fax

Practice location:
  • Phone: 877-734-2031
  • Fax:
Mailing address:
  • Phone: 877-734-2031
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number5628
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: