MEDICARE: VANESSA VACCARO

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.5260	OH

General Provider Information

NPI Number	:	1932576428
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANESSA VACCARO

Provider Business Mailing Address
First Line	:	2300 GRAYBILL RD
Second Line	:
City	:	UNIONTOWN
State	:	OH
Zip	:	44685-8119
Country	:	US
Telephone Number	:	330-896-7759
Fax Number	:

Provider Business Practice Location Address
First Line	:	2300 GRAYBILL RD
Second Line	:
City	:	UNIONTOWN
State	:	OH
Zip	:	44685-8119
Country	:	US
Telephone Number	:	330-896-7759
Fax Number	:

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

Provider Enumeration Date	:	08/31/2015
Last Update Date	:	08/31/2015

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Directions to “ VANESSA VACCARO ” Practice Location

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