Provider Demographics
NPI:1114264447
Name:OHLHAVER, CHARLES T
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:T
Last Name:OHLHAVER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 KIMBALL RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-2403
Mailing Address - Country:US
Mailing Address - Phone:443-695-9894
Mailing Address - Fax:
Practice Address - Street 1:15 KIMBALL RIDGE CT
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-2403
Practice Address - Country:US
Practice Address - Phone:443-695-9894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCM108106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist