Provider Demographics
NPI:1043760408
Name:LEHTO, CHARLOTTE (ED S)
Entity Type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:
Last Name:LEHTO
Suffix:
Gender:F
Credentials:ED S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6620 SANBORN RD
Mailing Address - Street 2:
Mailing Address - City:ASHTABULA
Mailing Address - State:OH
Mailing Address - Zip Code:44004-9552
Mailing Address - Country:US
Mailing Address - Phone:440-993-2618
Mailing Address - Fax:440-993-2647
Practice Address - Street 1:6620 SANBORN RD
Practice Address - Street 2:
Practice Address - City:ASHTABULA
Practice Address - State:OH
Practice Address - Zip Code:44004-9552
Practice Address - Country:US
Practice Address - Phone:440-993-2618
Practice Address - Fax:440-993-2647
Is Sole Proprietor?:No
Enumeration Date:2016-10-10
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHP-SS-S KU1-00-8873103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool