Provider Demographics
NPI:1609272608
Name:WILHITE, MYRITA YVONNE (AUD)
Entity Type:Individual
Prefix:DR
First Name:MYRITA
Middle Name:YVONNE
Last Name:WILHITE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 EUCLID AVE
Mailing Address - Street 2:MC 430
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44115-2214
Mailing Address - Country:US
Mailing Address - Phone:216-687-3808
Mailing Address - Fax:216-687-6993
Practice Address - Street 1:2121 EUCLID AVE
Practice Address - Street 2:MC 430
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44115-2214
Practice Address - Country:US
Practice Address - Phone:216-687-3808
Practice Address - Fax:216-687-6993
Is Sole Proprietor?:No
Enumeration Date:2014-11-18
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA00654231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0408286Medicaid
OH366525OtherMEDICARE PTAN