Provider Demographics
NPI:1649689886
Name:SUPER, HOPE ANNE (MA CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:HOPE
Middle Name:ANNE
Last Name:SUPER
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:MISS
Other - First Name:HOPE
Other - Middle Name:ANNE
Other - Last Name:MERKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA CCC-SLP
Mailing Address - Street 1:100 7TH AV SUITE 255
Mailing Address - Street 2:
Mailing Address - City:CHARDON
Mailing Address - State:OH
Mailing Address - Zip Code:44024
Mailing Address - Country:US
Mailing Address - Phone:440-285-0775
Mailing Address - Fax:440-285-2091
Practice Address - Street 1:100 7TH AV SUITE 255
Practice Address - Street 2:
Practice Address - City:CHARDON
Practice Address - State:OH
Practice Address - Zip Code:44024
Practice Address - Country:US
Practice Address - Phone:440-285-0775
Practice Address - Fax:440-285-2091
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-12
Last Update Date:2018-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH235Z00000X
OHSP11800235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0130184Medicaid