Doctor Name: | MS. ANNE B MAHOLM |
NPI Number: | 1700177581 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 12144215 |
Business Practice Address: | 3560 W Market St Ste 400 Fairlawn, OH - 443332665 |
Business Phone Number: | 3306684041 |
Business Fax Number: | 3306665626 |
Mailing Address: | 461 Starling Ct Apt 310, WADSWORTH |
State: | OH |
Postal Code: | 442817925 |
Phone Number: | 3304726597 |
Fax Number: | 3306665626 |
NPI Enumeration Date: | 04/27/2011 |
NPI Last Update Date: | 04/27/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 12144215 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
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 |