Provider Demographics
NPI:1841359734
Name:WITMER, ESTHER VIOLA (LISW)
Entity type:Individual
Prefix:MS
First Name:ESTHER
Middle Name:VIOLA
Last Name:WITMER
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTAINE
Mailing Address - State:OH
Mailing Address - Zip Code:43311-1508
Mailing Address - Country:US
Mailing Address - Phone:937-599-2766
Mailing Address - Fax:937-599-3151
Practice Address - Street 1:1600 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BELLEFONTAINE
Practice Address - State:OH
Practice Address - Zip Code:43311-1508
Practice Address - Country:US
Practice Address - Phone:937-599-2766
Practice Address - Fax:937-599-3151
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI0005952101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health