Provider Demographics
NPI:1811482243
Name:KUNTZ, ELIZABETH EVANGELINE
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:EVANGELINE
Last Name:KUNTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 HAMILTON DR
Mailing Address - Street 2:
Mailing Address - City:TORONTO
Mailing Address - State:OH
Mailing Address - Zip Code:43964-2004
Mailing Address - Country:US
Mailing Address - Phone:740-632-7796
Mailing Address - Fax:
Practice Address - Street 1:81 HAMILTON DR
Practice Address - Street 2:
Practice Address - City:TORONTO
Practice Address - State:OH
Practice Address - Zip Code:43964-2004
Practice Address - Country:US
Practice Address - Phone:740-996-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-27
Last Update Date:2025-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.2303732-SUPV101YP2500X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional