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NPI Code Detail

MEDICARE: KATHRYN GOLTL M.A. CCC-SLP

MEDICARE: KATHRYN GOLTL 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.11496OH

General Provider Information

NPI Number : 1306203559
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYN GOLTL M.A. CCC-SLP
Provider Business Mailing Address
First Line : 16600 W SPRAGUE RD
Second Line :
City : CLEVELAND
State : OH
Zip : 44130-6318
Country : US
Telephone Number : 216-227-7700
Fax Number :
Provider Business Practice Location Address
First Line : 26376 JOHN RD
Second Line :
City : OLMSTED TWP
State : OH
Zip : 44138-1277
Country : US
Telephone Number : 440-235-7100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2016
Last Update Date : 01/19/2016

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Directions to “ KATHRYN GOLTL M.A. CCC-SLP” Practice Location

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