Healthcare Provider Details

I. General information

NPI: 1023164258
Provider Name (Legal Business Name): TRICIA LYNN MOEHRING M.A.-CCC, SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 10/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56 COOPER AVE
CLEVES OH
45002-1002
US

IV. Provider business mailing address

8378 MACY LN
CLEVES OH
45002-1418
US

V. Phone/Fax

Practice location:
  • Phone: 513-467-3500
  • Fax:
Mailing address:
  • Phone: 513-265-0324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP.7487
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: