MEDICARE: LAURA MASSA SLP-CCC

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	SP.8238	OH

General Provider Information

NPI Number	:	1659896009
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA MASSA SLP-CCC

Provider Business Mailing Address
First Line	:	7142 TRESSEL WOOD DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45248-1913
Country	:	US
Telephone Number	:	513-364-4398
Fax Number	:

Provider Business Practice Location Address
First Line	:	7142 TRESSEL WOOD DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45248-1913
Country	:	US
Telephone Number	:	513-364-4398
Fax Number	:

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

Provider Enumeration Date	:	08/07/2017
Last Update Date	:	07/21/2022

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Directions to “ LAURA MASSA SLP-CCC” Practice Location

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