Healthcare Provider Details

I. General information

NPI: 1144043423
Provider Name (Legal Business Name): HUSNA ARA SHARIFF
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2024
Last Update Date: 11/05/2024
Certification Date: 11/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1483 PEARL RD
BRUNSWICK OH
44212-3416
US

IV. Provider business mailing address

2736 MEDINA RD STE 108
MEDINA OH
44256-9801
US

V. Phone/Fax

Practice location:
  • Phone: 330-273-0500
  • Fax:
Mailing address:
  • Phone: 330-952-0403
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP.14302
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: