Provider Demographics
NPI:1396975918
Name:SPEECH LANGUAGE PATH, LLC
Entity type:Organization
Organization Name:SPEECH LANGUAGE PATH, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LUCINDA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:MOREHEAD
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:614-505-7330
Mailing Address - Street 1:7100 N HIGH ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-2316
Mailing Address - Country:US
Mailing Address - Phone:614-505-7330
Mailing Address - Fax:614-388-5808
Practice Address - Street 1:7100 N HIGH ST
Practice Address - Street 2:SUITE 203
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-2316
Practice Address - Country:US
Practice Address - Phone:614-505-7330
Practice Address - Fax:614-388-5808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-16
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3958235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty