Provider Demographics
NPI:1952355612
Name:BINZLEY, VERONICA (PHD)
Entity Type:Individual
Prefix:DR
First Name:VERONICA
Middle Name:
Last Name:BINZLEY
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 1:24100 CHAGRIN BLVD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5535
Mailing Address - Country:US
Mailing Address - Phone:216-831-1040
Mailing Address - Fax:216-831-2667
Practice Address - Street 1:24100 CHAGRIN BLVD
Practice Address - Street 2:SUITE 400
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5535
Practice Address - Country:US
Practice Address - Phone:216-831-1040
Practice Address - Fax:216-831-2667
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1609103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHO353424Medicaid
OHO353424Medicaid