MEDICARE: DR. NATALIE MICHELE WHITLOW PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC1900X	Counseling Psychologist	6899	OH

General Provider Information

NPI Number	:	1467710384
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NATALIE MICHELE WHITLOW PH.D.

Provider Business Mailing Address
First Line	:	1435 MARKET AVE N
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44714-2609
Country	:	US
Telephone Number	:	573-424-5060
Fax Number	:

Provider Business Practice Location Address
First Line	:	1435 MARKET AVE N
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44714-2609
Country	:	US
Telephone Number	:	573-424-5060
Fax Number	:	216-671-7543

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/28/2012
Last Update Date	:	04/28/2012

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