Provider Demographics
NPI:1447588272
Name:DYNAMICALLY SPEAKING
Entity Type:Organization
Organization Name:DYNAMICALLY SPEAKING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JOCQEELA
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:MCWHORTER
Authorized Official - Suffix:
Authorized Official - Credentials:OHIO LICENSURE
Authorized Official - Phone:216-973-9268
Mailing Address - Street 1:404 TERRACE LN BLDG 5
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:OH
Mailing Address - Zip Code:44144-3212
Mailing Address - Country:US
Mailing Address - Phone:216-973-9268
Mailing Address - Fax:
Practice Address - Street 1:404 TERRACE LN BLDG 5
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:OH
Practice Address - Zip Code:44144-3212
Practice Address - Country:US
Practice Address - Phone:216-973-9268
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-07
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP. 8750235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty