Provider Demographics
NPI:1245655695
Name:HOVERMAN, CELESTE (MED, CCC-SLP)
Entity type:Individual
Prefix:
First Name:CELESTE
Middle Name:
Last Name:HOVERMAN
Suffix:
Gender:F
Credentials:MED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:816 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45805-2025
Mailing Address - Country:US
Mailing Address - Phone:419-996-3390
Mailing Address - Fax:419-996-3391
Practice Address - Street 1:816 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45805-2025
Practice Address - Country:US
Practice Address - Phone:419-996-3390
Practice Address - Fax:419-996-3391
Is Sole Proprietor?:No
Enumeration Date:2014-02-21
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7790235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist