Provider Demographics
NPI:1184698417
Name:JAMES, ELISABETH B (PHD)
Entity type:Individual
Prefix:MS
First Name:ELISABETH
Middle Name:B
Last Name:JAMES
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 1:4235 DEEPWOOD LN
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-5515
Mailing Address - Country:US
Mailing Address - Phone:419-353-8015
Mailing Address - Fax:419-385-0204
Practice Address - Street 1:2639 UPTON AVE
Practice Address - Street 2:THOMBRE AND ASSOCIATES
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-3936
Practice Address - Country:US
Practice Address - Phone:419-471-1848
Practice Address - Fax:419-471-0037
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-14
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5169103T00000X
NY10581103T00000X
MD2341103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0593237Medicaid
OHJACP31111Medicare ID - Type Unspecified