Provider Demographics
NPI:1659090017
Name:MUSCH, LYDIA HELENA (MA CCC SLP)
Entity Type:Individual
Prefix:
First Name:LYDIA
Middle Name:HELENA
Last Name:MUSCH
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 1:3900 COTTINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45241-1616
Mailing Address - Country:US
Mailing Address - Phone:513-864-1000
Mailing Address - Fax:
Practice Address - Street 1:3900 COTTINGHAM DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241-1616
Practice Address - Country:US
Practice Address - Phone:513-864-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-26
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.15567235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCOND.20222090-SPOtherSPEECH AND HEARING PROFESSIONAL BOARD