Provider Demographics
NPI:1205057122
Name:MIAMI UNIVERSITY SPEECH & HEARING CLINIC
Entity type:Organization
Organization Name:MIAMI UNIVERSITY SPEECH & HEARING CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPT CHAIR SPEECH PATHOLOGY & AUDIO
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:HUTCHINSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD CCC A
Authorized Official - Phone:513-529-2509
Mailing Address - Street 1:2 BACHELOR HALL
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45056
Mailing Address - Country:US
Mailing Address - Phone:513-529-2500
Mailing Address - Fax:513-529-2502
Practice Address - Street 1:2 BACHELOR HALL
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:OH
Practice Address - Zip Code:45056
Practice Address - Country:US
Practice Address - Phone:513-529-2500
Practice Address - Fax:513-529-2502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH235Z00000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2148787Medicaid
OH9302431Medicare ID - Type Unspecified
OH2148787Medicaid