Provider Demographics
NPI:1477755205
Name:WITTMAN, BETH A (MSW)
Entity Type:Individual
Prefix:MS
First Name:BETH
Middle Name:A
Last Name:WITTMAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2266 E. MAIN STREET
Mailing Address - Street 2:SUITE E
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43209-3910
Mailing Address - Country:US
Mailing Address - Phone:614-237-1131
Mailing Address - Fax:614-237-1131
Practice Address - Street 1:2266 E. MAIN STREET
Practice Address - Street 2:E
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43209-3910
Practice Address - Country:US
Practice Address - Phone:614-237-1131
Practice Address - Fax:614-237-1131
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-40281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical