# LAKE COUNTY PEDIATRIC SPEECH & LANGUAGE THERAPY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750973806
- **Authorized official:** MARCEE JONES (ACCOUNT COORDINATOR)
- **Authorized official phone:** (410) 824-1480

## Contact information

- **Practice address:** 7537 MENTOR AVE STE 303, MENTOR, OH 44060-5463
- **Practice address phone:** (440) 567-7166
- **Mailing address:** 7537 MENTOR AVE STE 303, MENTOR, OH 44060-5463
- **Mailing address phone:** (440) 567-7166

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 235Z00000X | Speech-Language Pathologist | — | — | Yes |

## Other

- **Enumeration date:** 02/10/2021
- **Last updated:** 08/01/2022