Provider Demographics
NPI:1609348507
Name:SIMCOX, DENISE LYNN (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:LYNN
Last Name:SIMCOX
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3625 MARSH RD
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-5823
Mailing Address - Country:US
Mailing Address - Phone:330-346-0060
Mailing Address - Fax:
Practice Address - Street 1:3625 MARSH RD
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-5823
Practice Address - Country:US
Practice Address - Phone:330-346-0060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-18
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP4590235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist