MEDICARE: DONALD D'AMORE 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-3332	OH

General Provider Information

NPI Number	:	1851716112
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONALD D'AMORE M.A. CCC-SLP

Provider Business Mailing Address
First Line	:	29570 DORCHESTER DR
Second Line	:
City	:	NORTH OLMSTED
State	:	OH
Zip	:	44070-5048
Country	:	US
Telephone Number	:	440-235-1323
Fax Number	:

Provider Business Practice Location Address
First Line	:	29570 DORCHESTER DR
Second Line	:
City	:	NORTH OLMSTED
State	:	OH
Zip	:	44070-5048
Country	:	US
Telephone Number	:	440-235-1323
Fax Number	:

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

Provider Enumeration Date	:	02/24/2014
Last Update Date	:	02/24/2014

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