Provider Demographics
NPI:1740013846
Name:PREVITS, MARY F
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:F
Last Name:PREVITS
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 1:4 JENNIFER WAY
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:OH
Mailing Address - Zip Code:44857-9563
Mailing Address - Country:US
Mailing Address - Phone:216-344-0850
Mailing Address - Fax:
Practice Address - Street 1:4 JENNIFER WAY
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:OH
Practice Address - Zip Code:44857-9563
Practice Address - Country:US
Practice Address - Phone:216-344-0850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-23
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH07681235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist