Provider Demographics
NPI:1033543947
Name:LINE, JOSELYN RAE (MA, CCC/SLP)
Entity Type:Individual
Prefix:MS
First Name:JOSELYN
Middle Name:RAE
Last Name:LINE
Suffix:
Gender:F
Credentials:MA, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 NORTHWOODS BLVD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-4716
Mailing Address - Country:US
Mailing Address - Phone:614-545-8300
Mailing Address - Fax:
Practice Address - Street 1:30 NORTHWOODS BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-4716
Practice Address - Country:US
Practice Address - Phone:614-545-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-27
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist