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General NPI Number Information
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NPI Number | 1154699510
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Entity Type | Individual
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Provider Name | KATIE MIRANDA LEMLEY SLP
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Gender | Female
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Dates
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Enumeration Date | 12/13/2011
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Last Update Date | 11/02/2018
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Provider Practice Location Address
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Address Line | 510 5TH ST
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City | BEVERLY
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State | OH
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Zip | 45715-8916
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Country | US
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Telephone | 740-984-2371
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Fax |
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Provider Business Mailing Address
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Address Line | 73 2ND ST
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City | VINCENT
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State | OH
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Zip | 45784-5014
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Country | US
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Telephone | 740-678-2499
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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 | COND2011099
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License Number State | OH
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