Provider Demographics
NPI:1922641372
Name:MARY ANN ECHOLS,PHD,LLC
Entity Type:Organization
Organization Name:MARY ANN ECHOLS,PHD,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ECHOLS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:330-610-3879
Mailing Address - Street 1:2302 TIBBETTS WICK RD
Mailing Address - Street 2:
Mailing Address - City:GIRARD
Mailing Address - State:OH
Mailing Address - Zip Code:44420-1231
Mailing Address - Country:US
Mailing Address - Phone:330-610-3879
Mailing Address - Fax:330-747-5431
Practice Address - Street 1:2302 TIBBETTS WICK RD
Practice Address - Street 2:
Practice Address - City:GIRARD
Practice Address - State:OH
Practice Address - Zip Code:44420-1231
Practice Address - Country:US
Practice Address - Phone:330-610-3879
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-17
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty