Provider Demographics
NPI:1811775760
Name:MONTEMARANO, ALEXIS NICOLETTE
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:NICOLETTE
Last Name:MONTEMARANO
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 1:3225 CARROLL AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44113-3432
Mailing Address - Country:US
Mailing Address - Phone:216-466-3430
Mailing Address - Fax:
Practice Address - Street 1:7000 PAULA DR
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-3561
Practice Address - Country:US
Practice Address - Phone:216-676-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-20
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.15623235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist