Doctor Name: | AUTUMN MCLENNAN |
NPI Number: | 1336510353 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 2016053 |
Business Practice Address: | 110 S Myrtle Ave Willard, OH - 448901425 |
Business Phone Number: | 4199350181 |
Business Fax Number: | |
Mailing Address: | 310 S Myrtle, WILLARD |
State: | OH |
Postal Code: | 44890 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 10/16/2015 |
NPI Last Update Date: | 10/16/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2016053 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |