| Doctor Name: | EILEEN MAHDIK-MORELLO |
| NPI Number: | 1023053113 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | I-0005336 |
| Business Practice Address: | 801 E Washington St Suite 150 Medina, OH - 442563335 |
| Business Phone Number: | 3307221069 |
| Business Fax Number: | 3307649712 |
| Mailing Address: | 801 E Washington St, Suite 150 MEDINA |
| State: | OH |
| Postal Code: | 442563335 |
| Phone Number: | 3307221069 |
| Fax Number: | 3307649712 |
| NPI Enumeration Date: | 06/20/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | I-0005336 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |