Provider Demographics
NPI:1841786514
Name:BLINE, ELIZABETH ANNETTE (NONE)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANNETTE
Last Name:BLINE
Suffix:
Gender:F
Credentials:NONE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:STEP BY STEP ACADEMY
Mailing Address - Street 2:445 EAST DUBLIN GRANVILLE ROAD
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-3183
Mailing Address - Country:US
Mailing Address - Phone:614-436-7837
Mailing Address - Fax:614-515-5779
Practice Address - Street 1:STEP BY STEP ACADEMY
Practice Address - Street 2:445 EAST DUBLIN GRANVILLE ROAD
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-3183
Practice Address - Country:US
Practice Address - Phone:614-436-7837
Practice Address - Fax:614-515-5779
Is Sole Proprietor?:No
Enumeration Date:2018-07-06
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator