MEDICARE: MISS PATRICIA M MCCLEERY M.A. CCC-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	231H00000X	Audiologist	A01497	OH

General Provider Information

NPI Number	:	1922139591
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS PATRICIA M MCCLEERY M.A. CCC-A

Provider Business Mailing Address
First Line	:	36100 EUCLID AVE STE 350
Second Line	:
City	:	WILLOUGHBY
State	:	OH
Zip	:	44094-4489
Country	:	US
Telephone Number	:	440-942-9308
Fax Number	:	440-942-8981

Provider Business Practice Location Address
First Line	:	36100 EUCLID AVE STE 350
Second Line	:
City	:	WILLOUGHBY
State	:	OH
Zip	:	44094-4489
Country	:	US
Telephone Number	:	440-942-9308
Fax Number	:	440-942-8981

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

Provider Enumeration Date	:	03/08/2007
Last Update Date	:	04/30/2008

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