Basic Information
| Provider Information | |||||||||
| NPI: | 1578868923 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FRASURE | ||||||||
| FirstName: | CLAIRE | ||||||||
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| Credential: | M.A. CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6709 ALBANY STATION DR | ||||||||
| Address2: | |||||||||
| City: | NEW ALBANY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 430548093 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6144145437 | ||||||||
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| Practice Location | |||||||||
| Address1: | 170 MILL ST | ||||||||
| Address2: | |||||||||
| City: | GAHANNA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432303036 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6144145437 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/17/2011 | ||||||||
| LastUpdateDate: | 01/12/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | COND.2011092-SP | OH | N | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | 235Z00000X | SP.10091 | OH | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.