Provider Demographics
NPI:1376173799
Name:O'TOOLE, CHLOE JANE
Entity type:Individual
Prefix:
First Name:CHLOE
Middle Name:JANE
Last Name:O'TOOLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:547 CHERRY ST SE APT 7G
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-4755
Mailing Address - Country:US
Mailing Address - Phone:616-450-2610
Mailing Address - Fax:
Practice Address - Street 1:547 CHERRY ST SE APT 7G
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-4755
Practice Address - Country:US
Practice Address - Phone:616-450-2610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-24
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101008278235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist