MEDICARE: CAROL S LIMBERT LERCH SPEECH THERAPIST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SP3566	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000140334	OTHER	OH	ANTHEM BLUE CROSS

General Provider Information

NPI Number	:	1003890377
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL S LIMBERT LERCH SPEECH THERAPIST

Provider Business Mailing Address
First Line	:	1605 ST RT 60
Second Line	:	STE 3
City	:	VERMILION
State	:	OH
Zip	:	44089
Country	:	US
Telephone Number	:	440-967-2508
Fax Number	:	440-967-4023

Provider Business Practice Location Address
First Line	:	1605 ST RT 60
Second Line	:	STE 3
City	:	VERMILION
State	:	OH
Zip	:	44089
Country	:	US
Telephone Number	:	440-967-2508
Fax Number	:	440-967-4023

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2005
Last Update Date	:	08/28/2007

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Directions to “ CAROL S LIMBERT LERCH SPEECH THERAPIST” Practice Location

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