Provider Demographics
NPI:1538244173
Name:MEHOSKY, KATHLEEN MARIE (MS,CCC-SLP)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:MARIE
Last Name:MEHOSKY
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5700 LOMBARDO CENTER
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SEVEN HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44131
Mailing Address - Country:US
Mailing Address - Phone:216-749-6650
Mailing Address - Fax:
Practice Address - Street 1:5700 LOMBARDO CTR
Practice Address - Street 2:SUITE 205
Practice Address - City:SEVEN HILLS
Practice Address - State:OH
Practice Address - Zip Code:44131-2540
Practice Address - Country:US
Practice Address - Phone:216-477-6650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2009-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP7649235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000217475OtherANTHEMBLUECROSS/BLUSHEILD
OH0842995Medicaid
OH4655AOtherBEECH STREET CORPORATION
OH341929047OtherTAX ID
OH366587Medicare PIN