Provider Demographics
NPI:1366091217
Name:TONNIS, CAROLYN (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:TONNIS
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 1:7301 JAMAICA WAY APT 6
Mailing Address - Street 2:
Mailing Address - City:MAINEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45039-8900
Mailing Address - Country:US
Mailing Address - Phone:513-253-5586
Mailing Address - Fax:
Practice Address - Street 1:150 E 6TH ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:OH
Practice Address - Zip Code:45005-2559
Practice Address - Country:US
Practice Address - Phone:937-743-5290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-04
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist