MEDICARE: MS. KATHLEEN D. K. SUTER M.A. 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
1	235Z00000X	Speech-Language Pathologist	SP.12248	OH

General Provider Information

NPI Number	:	1760946537
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KATHLEEN D. K. SUTER M.A. CCC-SLP

Provider Business Mailing Address
First Line	:	1310 HARVARD BLVD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43614-2923
Country	:	US
Telephone Number	:	419-351-5832
Fax Number	:

Provider Business Practice Location Address
First Line	:	1310 HARVARD BLVD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43614-2923
Country	:	US
Telephone Number	:	419-351-5832
Fax Number	:

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

Provider Enumeration Date	:	01/25/2019
Last Update Date	:	01/25/2019

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