Provider Demographics
NPI:1063069219
Name:SPRING, VANESSA MARY (MED)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:MARY
Last Name:SPRING
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3044 LAKE JAMES TER
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312-4624
Mailing Address - Country:US
Mailing Address - Phone:419-961-3946
Mailing Address - Fax:
Practice Address - Street 1:5311 LONGWOOD AVE
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44134-3800
Practice Address - Country:US
Practice Address - Phone:440-885-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-22
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.07231235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist