MEDICARE: MRS. LINDSEY R ROSE M.A.

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-9120	OH

General Provider Information

NPI Number	:	1811139975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LINDSEY R ROSE M.A.

Provider Business Mailing Address
First Line	:	3100 LINWOOD AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45208-2921
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2121 MADISON RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45208-3220
Country	:	US
Telephone Number	:	513-871-6080
Fax Number	:

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

Provider Enumeration Date	:	04/03/2009
Last Update Date	:	04/03/2009

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Directions to “ MRS. LINDSEY R ROSE M.A.” Practice Location

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