MEDICARE: ROSEMARIE DONATELLI

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	235Z00000X	Speech-Language Pathologist		OH

General Provider Information

NPI Number	:	1700059904
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSEMARIE DONATELLI

Provider Business Mailing Address
First Line	:	105 MAY CT
Second Line	:
City	:	CHAGRIN FALLS
State	:	OH
Zip	:	44022-3211
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	105 MAY CT
Second Line	:
City	:	CHAGRIN FALLS
State	:	OH
Zip	:	44022-3211
Country	:	US
Telephone Number	:	440-382-2369
Fax Number	:

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

Provider Enumeration Date	:	04/08/2008
Last Update Date	:	04/08/2008

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Directions to “ ROSEMARIE DONATELLI ” Practice Location

Language	Start Address	Practice Location

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