Healthcare Provider Details

I. General information

NPI: 1396455929
Provider Name (Legal Business Name): BETH ANN HOHMAN MS,CCC-SP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2022
Last Update Date: 12/05/2022
Certification Date: 12/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE # DESKA71
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

9500 EUCLID AVE # DESKA71
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 216-645-9573
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number3555
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: