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NPI Code Detail

MEDICARE: AMY NALLY M.A. CCC-SLP

MEDICARE: AMY NALLY 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
1235Z00000XSpeech-Language PathologistCOND. 2014288-SPOH
2235Z00000XSpeech-Language PathologistSP.11583OH

General Provider Information

NPI Number : 1841604477
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY NALLY M.A. CCC-SLP
Provider Business Mailing Address
First Line : 1578 LAKELAND AVE
Second Line :
City : LAKEWOOD
State : OH
Zip : 44107-3817
Country : US
Telephone Number : 440-336-4716
Fax Number :
Provider Business Practice Location Address
First Line : 33355 HEALTH CAMPUS BLVD
Second Line :
City : AVON
State : OH
Zip : 44011-1399
Country : US
Telephone Number : 440-937-9099
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2014
Last Update Date : 05/13/2024

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Directions to “ AMY NALLY M.A. CCC-SLP” Practice Location

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