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General NPI Number Information
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NPI Number | 1043397458
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Entity Type | Organization
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Legal Business Name | CLEVELAND HEARING AND SPEECH CENTER
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 06/05/2020
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Provider Practice Location Address
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Address Line | 11635 EUCLID AVE
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City | CLEVELAND
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State | OH
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Zip | 44106-4319
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Country | US
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Telephone | 216-231-8787
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Fax | 216-231-7141
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Provider Business Mailing Address
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Address Line | 11635 EUCLID AVE
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City | CLEVELAND
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State | OH
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Zip | 44106-4319
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Country | US
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Telephone | 216-231-8787
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Fax | 216-231-7141
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. JENNELL C. VICK
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Credential | PHD
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Telephone | 216-231-8787
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | A-00915
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP-5730
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License Number State | OH
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