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NPI Code Detail

MEDICARE: SAMANTHA FITZENRIDER MM, MA, CCC-SLP

MEDICARE: SAMANTHA FITZENRIDER MM, 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 PathologistSP.11809OH

General Provider Information

NPI Number : 1679957286
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA FITZENRIDER MM, MA, CCC-SLP
Provider Business Mailing 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 :
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 : 07/13/2015
Last Update Date : 07/13/2015

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Directions to “ SAMANTHA FITZENRIDER MM, MA, CCC-SLP” Practice Location

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