Provider Demographics
NPI:1649599754
Name:SCHWARTZ, BLAIR (MA AUD)
Entity Type:Individual
Prefix:
First Name:BLAIR
Middle Name:
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:MA AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 RICHLAND MALL
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44906-1246
Mailing Address - Country:US
Mailing Address - Phone:419-624-0336
Mailing Address - Fax:419-624-1757
Practice Address - Street 1:600 RICHLAND MALL
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906-1246
Practice Address - Country:US
Practice Address - Phone:419-624-0336
Practice Address - Fax:419-624-1757
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-28
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA0186231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist