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General NPI Number Information
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NPI Number | 1609730696
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Entity Type | Individual
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Provider Name | LILY BOTOS
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Gender |
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Dates
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Enumeration Date | 12/12/2025
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 2121 ASHLAND ST
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City | LOUISVILLE
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State | OH
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Zip | 44641-9031
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Country | US
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Telephone | 330-479-3440
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Fax |
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Provider Business Mailing Address
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Address Line | 1174 DIETZ AVE
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City | AKRON
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State | OH
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Zip | 44301-1918
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Country | US
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Telephone |
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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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