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General NPI Number Information
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NPI Number | 1902038391
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Entity Type | Organization
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Legal Business Name | CORNERSTONE SPEECH THERAPY LLC
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Dates
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Enumeration Date | 08/18/2009
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Last Update Date | 08/04/2011
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Provider Practice Location Address
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Address Line | 7540 SAWMILL PKWY SUITE A-2
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City | POWELL
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State | OH
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Zip | 43065-9845
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Country | US
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Telephone | 614-973-9755
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 16092
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City | COLUMBUS
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State | OH
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Zip | 43216-6092
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Country | US
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Telephone | 614-973-9755
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Fax |
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Authorized Official
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Title or Position | MANAGER OF FINANCE
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Name | MR. MICHAEL J PICKENS
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Credential |
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Telephone | 614-973-9755
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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.7127
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License Number State | OH
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