Provider Demographics
NPI:1417962804
Name:LIGUZINSKI, RITA MARIE (SLP)
Entity Type:Individual
Prefix:MRS
First Name:RITA
Middle Name:MARIE
Last Name:LIGUZINSKI
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 1:7557 SANCTUARY CIR
Mailing Address - Street 2:
Mailing Address - City:BRECKSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44141-3194
Mailing Address - Country:US
Mailing Address - Phone:440-740-0184
Mailing Address - Fax:216-901-2803
Practice Address - Street 1:5000 ROCKSIDE RD STE 500
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:OH
Practice Address - Zip Code:44131-2178
Practice Address - Country:US
Practice Address - Phone:216-459-2846
Practice Address - Fax:216-901-2803
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP-1157235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3158621Medicaid
OH11576298OtherCAQH