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General NPI Number Information
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NPI Number | 1669924999
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Entity Type | Organization
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Legal Business Name | CLOUGH CONSULTANTS AND SPEECH THERAPY, INC.
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Dates
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Enumeration Date | 11/03/2016
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Last Update Date | 11/03/2016
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Provider Practice Location Address
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Address Line | 30249 CENTER RIDGE RD
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City | WESTLAKE
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State | OH
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Zip | 44145-5130
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Country | US
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Telephone | 330-475-4048
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Fax |
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Provider Business Mailing Address
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Address Line | 30249 CENTER RIDGE RD
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City | WESTLAKE
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State | OH
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Zip | 44145-5130
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Country | US
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Telephone | 330-475-4048
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Fax |
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | MRS. ANNE E CLOUGH
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Credential | MA SLP/CCC
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Telephone | 330-475-4048
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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 | SP.11064
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License Number State | OH
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