Provider Demographics
NPI:1649412529
Name:HORWITZ, LACEY MARIE (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LACEY
Middle Name:MARIE
Last Name:HORWITZ
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 1:23875 COMMERCE PARK STE 105
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5834
Mailing Address - Country:US
Mailing Address - Phone:216-292-7370
Mailing Address - Fax:216-292-7042
Practice Address - Street 1:23875 COMMERCE PARK STE 105
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5834
Practice Address - Country:US
Practice Address - Phone:216-292-7370
Practice Address - Fax:216-292-7042
Is Sole Proprietor?:No
Enumeration Date:2009-03-24
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP-9132235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist