Provider Demographics
NPI:1922065697
Name:WHITMORE, EVE P (PHD)
Entity Type:Individual
Prefix:
First Name:EVE
Middle Name:P
Last Name:WHITMORE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:EVE
Other - Middle Name:P
Other - Last Name:FISHER WHITMORE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:4833 DARROW RD STE 101
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-1411
Mailing Address - Country:US
Mailing Address - Phone:330-650-5338
Mailing Address - Fax:330-342-3837
Practice Address - Street 1:4833 DARROW RD STE 101
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-1411
Practice Address - Country:US
Practice Address - Phone:330-650-5338
Practice Address - Fax:330-342-3837
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4305103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0877207Medicaid
OH0877207Medicaid