Provider Demographics
NPI:1295025617
Name:PLAS, DAVID L (LPC & SLP)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:L
Last Name:PLAS
Suffix:
Gender:M
Credentials:LPC & SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15569 BAY RD
Mailing Address - Street 2:
Mailing Address - City:WAPAKONETA
Mailing Address - State:OH
Mailing Address - Zip Code:45895-9531
Mailing Address - Country:US
Mailing Address - Phone:419-303-3086
Mailing Address - Fax:
Practice Address - Street 1:15569 BAY RD
Practice Address - Street 2:
Practice Address - City:WAPAKONETA
Practice Address - State:OH
Practice Address - Zip Code:45895-9531
Practice Address - Country:US
Practice Address - Phone:419-303-3086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-19
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0000314101YP2500X
OH0073235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional