Provider Demographics
NPI:1821571985
Name:VARNER, MIKKI
Entity Type:Individual
Prefix:
First Name:MIKKI
Middle Name:
Last Name:VARNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52171 NATIONAL RD LOT 6
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-8398
Mailing Address - Country:US
Mailing Address - Phone:740-449-2371
Mailing Address - Fax:740-449-2382
Practice Address - Street 1:52171 NATIONAL RD LOT 6
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-8398
Practice Address - Country:US
Practice Address - Phone:740-449-2371
Practice Address - Fax:740-449-2382
Is Sole Proprietor?:No
Enumeration Date:2018-09-13
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHTP.11145237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist