Doctor Name: | MRS. JESSICA JENELLE BLAHA |
NPI Number: | 1356606610 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA CCC-SLP |
License Number: | SP7491 |
Business Practice Address: | 10639 Grant St Suite A Chardon, OH - 440241281 |
Business Phone Number: | 4406673832 |
Business Fax Number: | |
Mailing Address: | 10639 Grant St, Suite A CHARDON |
State: | OH |
Postal Code: | 440241281 |
Phone Number: | 4406673832 |
Fax Number: | |
NPI Enumeration Date: | 07/11/2012 |
NPI Last Update Date: | 07/11/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SP7491 |
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 |