Provider Demographics
NPI:1922476381
Name:COMUZIE, KATHERINE ZIMMER (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ZIMMER
Last Name:COMUZIE
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 1:4396 VANDEMARK RD
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44253-9793
Mailing Address - Country:US
Mailing Address - Phone:419-357-6740
Mailing Address - Fax:
Practice Address - Street 1:150 N MILLER RD # A
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-3770
Practice Address - Country:US
Practice Address - Phone:330-867-2240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-02
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN46002843A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH14065870OtherSTATE LICENSURE