Wetherwax, Colleen
Wetherwax, Colleen is an sole proprietor health care provider with primary practice located at 13300 Aquilla Rd , Chardon OH 44024-7944. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Wetherwax, Colleen can be contacted via phone (440) 279-2090.Contact Information
Primary practice address
13300 Aquilla Rd
Chardon OH 44024-7944
Phone: (440) 279-2090
Fax: (440) 285-2574
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | I2002109 | Ohio |
Profile Details
| NPI number | 1669820734 |
|---|---|
| LBN Legal business name | Wetherwax, Colleen |
| Credentials | LISW |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 31st, 2016 |
| Last updated | May 22nd, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669820734 | NPPES |
| Ohio | MEDICAID | 0265005 |
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