MEDICARE: KATHERINE FIFE

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	SP-2892	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01026595	OTHER		AMERICAN SPEECH-LANGUAGE-HEARING ASSOC MEMBER NUMBER

General Provider Information

NPI Number	:	1720403157
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE FIFE

Provider Business Mailing Address
First Line	:	38720 SALTWELL RD
Second Line	:
City	:	LISBON
State	:	OH
Zip	:	44432-8303
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	38720 SALTWELL RD
Second Line	:
City	:	LISBON
State	:	OH
Zip	:	44432-8303
Country	:	US
Telephone Number	:	330-424-9591
Fax Number	:

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

Provider Enumeration Date	:	02/21/2014
Last Update Date	:	02/21/2014

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Directions to “ KATHERINE FIFE ” Practice Location

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