Provider Demographics
NPI:1548273535
Name:ECHOLS, MARY ANN (PHD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:ANN
Last Name:ECHOLS
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 1:346 TOD LN
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44504-1446
Mailing Address - Country:US
Mailing Address - Phone:330-747-5431
Mailing Address - Fax:
Practice Address - Street 1:2031 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-2401
Practice Address - Country:US
Practice Address - Phone:330-740-9200
Practice Address - Fax:330-740-9231
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5726103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling