MEDICARE: CHLOE JANE O'TOOLE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	7101008278	MI

General Provider Information

NPI Number	:	1376173799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHLOE JANE O'TOOLE

Provider Business Mailing Address
First Line	:	547 CHERRY ST SE APT 7G
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49503-4755
Country	:	US
Telephone Number	:	616-450-2610
Fax Number	:

Provider Business Practice Location Address
First Line	:	547 CHERRY ST SE APT 7G
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49503-4755
Country	:	US
Telephone Number	:	616-450-2610
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2020
Last Update Date	:	04/18/2025

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Directions to “ CHLOE JANE O'TOOLE ” Practice Location

Language	Start Address	Practice Location

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