Chelsey Mirto

Individual provider Active NPI Speech-Language Pathologist · Lagrange, OH

NPI 1396116752 · NPPES record last updated Oct 21, 2019

Key facts

NPI
1396116752
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SP.12182 (OH)
Practice address
531 Opportunity Way
Lagrange, OH 44050
Phone
(440) 355-2300
Fax
(440) 355-4240
NPI assigned
Oct 12, 2015
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)
No

State licenses

LicenseStateTypeSpecialty
SP.12182OHMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP.12182 OH Yes

Addresses

Primary practice location

531 Opportunity Way
Lagrange, OH 44050

Mailing address

531 Opportunity Way
Lagrange, OH 44050
Phone (440) 355-2300

Other names

  • Chelsey Fries Former name

Other providers in Lagrange, OH

All providers in Lagrange, OH · Speech-Language Pathologist in Ohio

Sources for this page

Verify at the official NPI Registry.