Provider Demographics
NPI:1255579934
Name:WESTLAKE HEARING & SPEECH CLINIC, INC.
Entity type:Organization
Organization Name:WESTLAKE HEARING & SPEECH CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/LICENSED SPEECH PATHOLOGI
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:KALL
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:440-835-6160
Mailing Address - Street 1:29101 HEALTH CAMPUS DR
Mailing Address - Street 2:SUITE 290
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-5270
Mailing Address - Country:US
Mailing Address - Phone:440-835-6160
Mailing Address - Fax:440-899-4373
Practice Address - Street 1:29101 HEALTH CAMPUS DR
Practice Address - Street 2:SUITE 290
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-5270
Practice Address - Country:US
Practice Address - Phone:440-835-6160
Practice Address - Fax:440-899-4373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-03
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation