Provider Demographics
NPI:1952635294
Name:RAVINE, CAROLYN ANNE (MS)
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:ANNE
Last Name:RAVINE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:
Other - Last Name:ZELINSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:150 N MILLER RD
Mailing Address - Street 2:BLDG. 150A
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-3770
Mailing Address - Country:US
Mailing Address - Phone:330-867-2240
Mailing Address - Fax:330-867-2245
Practice Address - Street 1:150 N MILLER RD
Practice Address - Street 2:BLDG. 150A
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:330-867-2245
Is Sole Proprietor?:No
Enumeration Date:2009-09-18
Last Update Date:2017-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP9382235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist