Provider Demographics
NPI:1649478926
Name:HILL, LARRY J (SLP)
Entity type:Individual
Prefix:
First Name:LARRY
Middle Name:J
Last Name:HILL
Suffix:
Gender:M
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 STOWER LN UNIT 7L
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:OH
Mailing Address - Zip Code:44857-2652
Mailing Address - Country:US
Mailing Address - Phone:574-261-2804
Mailing Address - Fax:
Practice Address - Street 1:1865 COUNTRYSIDE DR
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:OH
Practice Address - Zip Code:43420-8748
Practice Address - Country:US
Practice Address - Phone:419-334-2602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-06
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22002562A235Z00000X
OHSP.03321235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist