Healthcare Provider Details

I. General information

NPI: 1134215924
Provider Name (Legal Business Name): LEAH C FREDERICK-TOTH AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LEAH C FREDERICK M.A.

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 09/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7227 GLENWOOD AVE
YOUNGSTOWN OH
44512-4853
US

IV. Provider business mailing address

7227 GLENWOOD AVE
YOUNGSTOWN OH
44512-4853
US

V. Phone/Fax

Practice location:
  • Phone: 330-629-2144
  • Fax: 330-629-2140
Mailing address:
  • Phone: 330-629-2144
  • Fax: 330-629-2140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberA-00902
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: