Provider Demographics
NPI:1114331915
Name:MOHAN, MARGARET HEARN (EDS)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:HEARN
Last Name:MOHAN
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2720 DERBY RD
Mailing Address - Street 2:
Mailing Address - City:OTTAWA HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:43615-2144
Mailing Address - Country:US
Mailing Address - Phone:419-349-1851
Mailing Address - Fax:
Practice Address - Street 1:2720 DERBY RD
Practice Address - Street 2:
Practice Address - City:OTTAWA HILLS
Practice Address - State:OH
Practice Address - Zip Code:43615-2144
Practice Address - Country:US
Practice Address - Phone:419-349-1851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-19
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH1231574103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist