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General NPI Number Information
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NPI Number | 1063052975
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Entity Type | Individual
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Provider Name | BLISSAMBER SNOW WHITE O'BRIEN
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Gender | Female
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Dates
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Enumeration Date | 01/08/2020
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Last Update Date | 11/08/2021
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Provider Practice Location Address
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Address Line | 4090 E 93RD ST
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City | CLEVELAND
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State | OH
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Zip | 44105-5163
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Country | US
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Telephone | 216-838-4559
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Fax |
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Provider Business Mailing Address
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Address Line | 2064 LEWIS DR
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City | LAKEWOOD
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State | OH
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Zip | 44107-6124
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Country | US
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Telephone | 330-281-5072
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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