Rachel Bollheimer

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

NPI 1760074504 · NPPES record last updated Feb 3, 2021

Key facts

NPI
1760074504
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
Practice address
11256 Bowen Rd
Mantua, OH 44255-9454
Phone
(330) 357-8204
NPI assigned
Feb 3, 2021
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X Yes

Addresses

Primary practice location

11256 Bowen Rd
Mantua, OH 44255-9454

Mailing address

11256 Bowen Rd
Mantua, OH 44255-9454

Other practice location 1

10919 Main St
Mantua, OH 44255-8923
Phone (330) 357-8205

Other providers in Mantua, OH

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

Sources for this page

Verify at the official NPI Registry.