Provider Demographics
NPI:1174605042
Name:HELLWIG, JANE MILLER (PHD)
Entity type:Individual
Prefix:DR
First Name:JANE
Middle Name:MILLER
Last Name:HELLWIG
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 1:7215 OLD OAK BLVD
Mailing Address - Street 2:A 210 C
Mailing Address - City:MIDDLEBURG HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-3340
Mailing Address - Country:US
Mailing Address - Phone:440-886-9626
Mailing Address - Fax:
Practice Address - Street 1:7215 OLD OAK BLVD
Practice Address - Street 2:A 210 C
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-3340
Practice Address - Country:US
Practice Address - Phone:440-886-9626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3298103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCP02131Medicare ID - Type Unspecified