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NPI Code Detail

MEDICARE: KATHLEEN M HARRISON SLP 3063

MEDICARE: KATHLEEN M HARRISON SLP 3063
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 PathologistSLP3063OH

General Provider Information

NPI Number : 1205963055
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN M HARRISON SLP 3063
Provider Business Mailing Address
First Line : 7398 PRESLEY AVE
Second Line :
City : MENTOR
State : OH
Zip : 44060-5705
Country : US
Telephone Number : 440-255-6518
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 : 216-299-9643
Fax Number : 216-635-3530
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2007
Last Update Date : 07/08/2007

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Directions to “ KATHLEEN M HARRISON SLP 3063” Practice Location

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