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NPI Code Detail

MEDICARE: LAURIE DEWINE MA,CCC-A

MEDICARE: LAURIE DEWINE MA,CCC-A
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
1231H00000XAudiologist318OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PL9350991OTHEROHGROUP PIN

General Provider Information

NPI Number : 1518920651
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURIE DEWINE MA,CCC-A
Provider Business Mailing Address
First Line : 3302 WESTBOURNE DR
Second Line :
City : CINCINNATI
State : OH
Zip : 45248-5133
Country : US
Telephone Number : 513-922-0123
Fax Number : 513-922-3572
Provider Business Practice Location Address
First Line : 3302 WESTBOURNE DR
Second Line :
City : CINCINNATI
State : OH
Zip : 45248-5133
Country : US
Telephone Number : 513-922-0123
Fax Number : 513-922-3572
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2006
Last Update Date : 07/08/2007

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Directions to “ LAURIE DEWINE MA,CCC-A” Practice Location

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