Healthcare Provider Details

I. General information

NPI: 1487519997
Provider Name (Legal Business Name): GIANNA DANIELLE BUKSZAR MA, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1267 FORD RD
CLEVELAND OH
44124-1428
US

IV. Provider business mailing address

1267 FORD RD
LYNDHURST OH
44124-1428
US

V. Phone/Fax

Practice location:
  • Phone: 724-600-6634
  • Fax:
Mailing address:
  • Phone: 724-600-6634
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP.15513
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: