Provider Demographics
NPI:1053507111
Name:MCLOUGHLIN, PATRICIA J (MA,,CCC-SLP, COM)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:J
Last Name:MCLOUGHLIN
Suffix:
Gender:F
Credentials:MA,,CCC-SLP, COM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6492 WESTSHORE DR
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-3053
Mailing Address - Country:US
Mailing Address - Phone:330-678-6470
Mailing Address - Fax:
Practice Address - Street 1:25 MILFORD DR
Practice Address - Street 2:SUITE 8
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-2749
Practice Address - Country:US
Practice Address - Phone:330-342-4680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-21
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP 2875235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist