MEDICARE: MS. MOLLY NOLAN WEBER M.A., CCC-SLP

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	SP6363	OH

General Provider Information

NPI Number	:	1013027697
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MOLLY NOLAN WEBER M.A., CCC-SLP

Provider Business Mailing Address
First Line	:	6642 BRANCH HILL GUINEA PIKE
Second Line	:
City	:	LOVELAND
State	:	OH
Zip	:	45140-9178
Country	:	US
Telephone Number	:	513-791-1458
Fax Number	:	513-791-4326

Provider Business Practice Location Address
First Line	:	6642 BRANCH HILL GUINEA PIKE
Second Line	:	FAMILY SPEECH & HEARING CLINIC, LLC
City	:	LOVELAND
State	:	OH
Zip	:	45140-9178
Country	:	US
Telephone Number	:	513-791-1458
Fax Number	:	513-791-4326

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

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	07/08/2007

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