Provider Demographics
NPI:1639504368
Name:BIERMANN, JEANETTE S (PHD)
Entity Type:Individual
Prefix:DR
First Name:JEANETTE
Middle Name:S
Last Name:BIERMANN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36297 SOUTHINGTON CT
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:OH
Mailing Address - Zip Code:44011-3431
Mailing Address - Country:US
Mailing Address - Phone:440-476-8137
Mailing Address - Fax:
Practice Address - Street 1:265 W MAIN ST
Practice Address - Street 2:SUITE 102
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-2461
Practice Address - Country:US
Practice Address - Phone:330-678-9210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-12
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7067103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist