Healthcare Provider Details

I. General information

NPI: 1922476381
Provider Name (Legal Business Name): KATHERINE ZIMMER COMUZIE M.A. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2015
Last Update Date: 12/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 N MILLER RD # A
FAIRLAWN OH
44333-3770
US

IV. Provider business mailing address

4396 VANDEMARK RD
LITCHFIELD OH
44253-9793
US

V. Phone/Fax

Practice location:
  • Phone: 330-867-2240
  • Fax:
Mailing address:
  • Phone: 419-357-6740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number46002843A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: