Provider Demographics
NPI:1972293660
Name:BIAS, LYDIA (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LYDIA
Middle Name:
Last Name:BIAS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1990 E 120TH ST APT 6
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-1982
Mailing Address - Country:US
Mailing Address - Phone:419-366-3440
Mailing Address - Fax:
Practice Address - Street 1:3570 WARRENSVILLE CENTER RD STE 106
Practice Address - Street 2:
Practice Address - City:SHAKER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44122-5226
Practice Address - Country:US
Practice Address - Phone:216-282-1582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-08
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.15341235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist