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NPI Code Detail

MEDICARE: MS. JENNIFER THIEL M.A., CCC-SLP

MEDICARE:  MS. JENNIFER  THIEL  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
1235Z00000XSpeech-Language PathologistSP-8090OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083792048
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JENNIFER THIEL M.A., CCC-SLP
Provider Business Mailing Address
First Line : 1440 LAKESIDE AVE E
Second Line :
City : CLEVELAND
State : OH
Zip : 44114-1137
Country : US
Telephone Number : 216-692-4180
Fax Number : 216-692-4181
Provider Business Practice Location Address
First Line : 1440 LAKESIDE AVE E
Second Line :
City : CLEVELAND
State : OH
Zip : 44114-1137
Country : US
Telephone Number : 216-692-4180
Fax Number : 216-692-4181
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 04/03/2014

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Directions to “ MS. JENNIFER THIEL M.A., CCC-SLP” Practice Location

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