MEDICARE: KYLE VALATKA H.A.S

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	235500000X	Speech/Language/Hearing Specialist/Technologist	IL.03437	OH

General Provider Information

NPI Number	:	1487242053
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYLE VALATKA H.A.S

Provider Business Mailing Address
First Line	:	2828 S ARLINGTON RD
Second Line	:
City	:	COVENTRY TOWNSHIP
State	:	OH
Zip	:	44312-4726
Country	:	US
Telephone Number	:	330-785-0800
Fax Number	:

Provider Business Practice Location Address
First Line	:	2828 S ARLINGTON RD
Second Line	:
City	:	COVENTRY TOWNSHIP
State	:	OH
Zip	:	44312-4726
Country	:	US
Telephone Number	:	330-785-0800
Fax Number	:

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

Provider Enumeration Date	:	01/08/2021
Last Update Date	:	01/08/2021

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Directions to “ KYLE VALATKA H.A.S” Practice Location

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