Provider Demographics
NPI:1619392768
Name:ENGLISH, CONSTANCE (MA, CCC-SLP/L)
Entity Type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:
Last Name:ENGLISH
Suffix:
Gender:F
Credentials:MA, CCC-SLP/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 GLENN ST
Mailing Address - Street 2:
Mailing Address - City:TIFFIN
Mailing Address - State:OH
Mailing Address - Zip Code:44883-3417
Mailing Address - Country:US
Mailing Address - Phone:419-447-2652
Mailing Address - Fax:419-448-5223
Practice Address - Street 1:20 GLENN ST
Practice Address - Street 2:
Practice Address - City:TIFFIN
Practice Address - State:OH
Practice Address - Zip Code:44883-3417
Practice Address - Country:US
Practice Address - Phone:419-447-2652
Practice Address - Fax:419-448-5223
Is Sole Proprietor?:No
Enumeration Date:2014-02-26
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP2629235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist