Jacqueline L Kovacic, MS,CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Chesterland, OH
NPI 1760726145 · NPPES record last updated Nov 25, 2012
Key facts
- NPI
- 1760726145
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SP-3521 (OH)
- Practice address
- 12395 Falcon Ridge Rd
Chesterland, OH 44026-2236 - Phone
- (440) 554-9332
- NPI assigned
- Nov 25, 2012
- 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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP-3521 | OH | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SP-3521 | OH | Yes |
Addresses
Primary practice location
12395 Falcon Ridge Rd
Chesterland, OH 44026-2236
Mailing address
12395 Falcon Ridge Rd
Chesterland, OH 44026-2236
Phone (440) 729-3637
Other providers in Chesterland, OH
- Deborah Kisicki
- Linda R Kolbe
- John Joseph Konieczny
- Leah Christine Kotheimer
- Mary Beth Kotheimer
- Katlyn Kuenzig
- Gerald Francis Lackey
- Susan Hamman Lackey
- Jessica R Ladow
- Margaret H Lahner
All providers in Chesterland, 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 Nov 25, 2012. 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.