Provider Demographics
NPI:1295973394
Name:HUMPHREY, NATALIE ELIZABETH (SLP)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:ELIZABETH
Last Name:HUMPHREY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:ELIZABETH
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:13952 CHIPPEWA TRL
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-6709
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:640 W MARKET ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44303-1413
Practice Address - Country:US
Practice Address - Phone:330-762-5425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-27
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH535590Medicare UPIN