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NPI Code Detail

MEDICARE: MRS. SUSANNA CLINE MA, CCC-SLP

MEDICARE: MRS. SUSANNA CLINE MA, 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 PathologistSP6587OH

General Provider Information

NPI Number : 1528498912
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SUSANNA CLINE MA, CCC-SLP
Provider Business Mailing Address
First Line : 4277 MENNONITE RD
Second Line :
City : MANTUA
State : OH
Zip : 44255-9295
Country : US
Telephone Number : 330-274-2675
Fax Number :
Provider Business Practice Location Address
First Line : 150 N MILLER RD STE 150A
Second Line :
City : FAIRLAWN
State : OH
Zip : 44333-3713
Country : US
Telephone Number : 330-867-2240
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2013
Last Update Date : 11/21/2013

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Directions to “ MRS. SUSANNA CLINE MA, CCC-SLP” Practice Location

Language Start Address Practice Location
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