Individual
JOHANNA LYNN VINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
3800 PARK EAST DR, BEACHWOOD, OH 44122-4316
(216) 825-2909
Mailing address
3800 PARK EAST DR, BEACHWOOD, OH 44122-4316
(216) 825-2909
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
OH 3133792
OH
235Z00000X
Speech-Language Pathologist
Primary
SP. 11099
OH
Other
Enumeration date
03/05/2013
Last updated
11/01/2016
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