Healthcare Provider Details

I. General information

NPI: 1962230185
Provider Name (Legal Business Name): MARLEE PAVLECHKO A.UD.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2024
Last Update Date: 07/25/2024
Certification Date: 07/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1749 CLEVELAND RD
WOOSTER OH
44691-2203
US

IV. Provider business mailing address

2042 HIDDEN LAKE DR APT D
STOW OH
44224-5324
US

V. Phone/Fax

Practice location:
  • Phone: 330-264-9699
  • Fax:
Mailing address:
  • Phone: 614-653-5171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberA.02539
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: