Provider Demographics
NPI:1093920712
Name:DIGIACOMO, MOLLIE S (SLP)
Entity Type:Individual
Prefix:MRS
First Name:MOLLIE
Middle Name:S
Last Name:DIGIACOMO
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6325 RAPID RUN RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45233-4555
Mailing Address - Country:US
Mailing Address - Phone:513-574-3200
Mailing Address - Fax:
Practice Address - Street 1:6325 RAPID RUN RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45233
Practice Address - Country:US
Practice Address - Phone:513-574-3200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSLP4232235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist