Provider Demographics
NPI:1265639983
Name:LAROCCA, AMY L (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:L
Last Name:LAROCCA
Suffix:
Gender:F
Credentials: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:PO BOX 834
Mailing Address - Street 2:
Mailing Address - City:TWINSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44087-0834
Mailing Address - Country:US
Mailing Address - Phone:330-227-4656
Mailing Address - Fax:844-921-1091
Practice Address - Street 1:2993 ZENAS CT
Practice Address - Street 2:
Practice Address - City:TWINSBURG
Practice Address - State:OH
Practice Address - Zip Code:44087-3200
Practice Address - Country:US
Practice Address - Phone:614-282-5429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH08927235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist