MEDICARE: LEA HOPE SEWELL

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	COND.20201515-SP	OH

General Provider Information

NPI Number	:	1811509755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEA HOPE SEWELL

Provider Business Mailing Address
First Line	:	499 LORRAINE BLVD
Second Line	:
City	:	PICKERINGTON
State	:	OH
Zip	:	43147-2213
Country	:	US
Telephone Number	:	614-371-1751
Fax Number	:

Provider Business Practice Location Address
First Line	:	841 E MAIN ST
Second Line	:
City	:	CHILLICOTHEE
State	:	OH
Zip	:	45601-3509
Country	:	US
Telephone Number	:	740-773-2638
Fax Number	:

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

Provider Enumeration Date	:	08/21/2020
Last Update Date	:	08/21/2020

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Directions to “ LEA HOPE SEWELL ” Practice Location

Language	Start Address	Practice Location

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