| The Ironwood Center | |
|
2211 River Rd Maumee OH 43537-3637 | |
| (419) 740-3052 | |
| (419) 893-0475 |
| Full Name | The Ironwood Center |
|---|---|
| Speciality | Psychologist |
| Location | 2211 River Rd, Maumee, Ohio |
| Authorized Official Name and Position | Christine A. Fair (CEO) |
| Authorized Official Contact | 4197403052 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Ironwood Center 2211 River Rd Maumee OH 43537-3637 Ph: (419) 740-3052 | The Ironwood Center 2211 River Rd Maumee OH 43537-3637 Ph: (419) 740-3052 |
| NPI Number | 1053883439 |
|---|---|
| Provider Enumeration Date | 12/22/2018 |
| Last Update Date | 02/10/2023 |
| Certification Date | 02/10/2023 |
| Medicare PECOS PAC ID | 6507106366 |
|---|---|
| Medicare Enrollment ID | O20190314001589 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053883439 | NPI | - | NPPES |
| 0346995 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Christine Ann Fair |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194906958 PECOS PAC ID: 3870651458 Enrollment ID: I20160502002395 |
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