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General NPI Number Information
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NPI Number | 1750961199
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Entity Type | Organization
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Legal Business Name | POLARIS SPEECH AND NEUROLOGICAL REHABILITATION, LLC
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Dates
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Enumeration Date | 04/09/2021
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 33595 BAINBRIDGE RD STE 105B
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City | SOLON
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State | OH
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Zip | 44139-2981
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Country | US
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Telephone | 330-227-4656
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Fax | 844-921-1091
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Provider Business Mailing Address
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Address Line | 33595 BAINBRIDGE RD STE 105B
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City | SOLON
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State | OH
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Zip | 44139-2981
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Country | US
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Telephone | 330-227-4656
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Fax | 844-921-1091
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Authorized Official
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Title or Position | OWNER
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Name | AMY L LAROCCA
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Credential |
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Telephone | 330-227-4656
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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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