Provider Demographics
NPI:1356691133
Name:PATTEN, IOMI (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:IOMI
Middle Name:
Last Name:PATTEN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2804 N HIGH ST
Mailing Address - Street 2:UNIT 82026
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-8000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2804 N HIGH ST
Practice Address - Street 2:UNIT 82026
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43202-8000
Practice Address - Country:US
Practice Address - Phone:850-471-1005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-19
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ 5994235Z00000X
OHSP.11651235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist