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NPI Code Detail

MEDICARE: GLORIA STANSBERRY M.A., CCC-SLP

MEDICARE: GLORIA STANSBERRY 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 Pathologist3409OH

General Provider Information

NPI Number : 1164557732
Entity Type Code : Individual
Provider Name (Legal Business Name) : GLORIA STANSBERRY M.A., CCC-SLP
Provider Business Mailing Address
First Line : 6222 BROOKSIDE DR
Second Line :
City : CLEVELAND
State : OH
Zip : 44144-1633
Country : US
Telephone Number : 216-398-8226
Fax Number :
Provider Business Practice Location Address
First Line : 4553 HINCKLEY INDUSTRIAL PKWY
Second Line :
City : CLEVELAND
State : OH
Zip : 44109-6009
Country : US
Telephone Number : 216-635-3502
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2007
Last Update Date : 01/06/2010

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Directions to “ GLORIA STANSBERRY M.A., CCC-SLP” Practice Location

Language Start Address Practice Location
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