Provider Demographics
NPI:1265108682
Name:D'AMICO, NATALIE MICHELLE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:MICHELLE
Last Name:D'AMICO
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1932 NILES CORTLAND RD NE STE S
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-1055
Mailing Address - Country:US
Mailing Address - Phone:330-856-1520
Mailing Address - Fax:330-856-7342
Practice Address - Street 1:7320 N PALMYRA RD
Practice Address - Street 2:
Practice Address - City:CANFIELD
Practice Address - State:OH
Practice Address - Zip Code:44406-9709
Practice Address - Country:US
Practice Address - Phone:330-533-8755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-17
Last Update Date:2022-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP14523235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist