Laura Bolin
Individual provider Active NPI Speech-Language Pathologist · Lakewood, OH
NPI 1366030256 · NPPES record last updated Jan 6, 2021
Key facts
- NPI
- 1366030256
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- COND.20201484-SP (OH)
- Practice address
- 13114 Detroit Ave
Lakewood, OH 44107-2840 - Phone
- (216) 529-4241
- NPI assigned
- Jan 6, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| COND.20201484-SP | OH | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | COND.20201484-SP | OH | Yes |
Addresses
Primary practice location
13114 Detroit Ave
Lakewood, OH 44107-2840
Mailing address
13114 Detroit Ave
Lakewood, OH 44107-2840
Phone (216) 529-4241
Other practice location 1
16601 Madison Ave
Lakewood, OH 44107-5438
Phone (216) 529-4261
Other providers in Lakewood, OH
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- Candice Boddy
- Victoria M. Bodner
- Shirin Boose
- Mark William Boron
- Marilyn Jane Boros
- Jennifer Borovica
- Kevin L. Borst
All providers in Lakewood, OH · Speech-Language Pathologist in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 6, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.