Healthcare Provider Details

I. General information

NPI: 1467214064
Provider Name (Legal Business Name): NATALIA F JUST M.A. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2024
Last Update Date: 01/29/2024
Certification Date: 01/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46450 252ND ST
COLTON SD
57018-5712
US

IV. Provider business mailing address

5711 BELMERE DR
PARMA OH
44129-5207
US

V. Phone/Fax

Practice location:
  • Phone: 605-446-3538
  • Fax:
Mailing address:
  • Phone: 330-592-0995
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP.15140
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: