Provider Demographics
NPI:1194132670
Name:EPSTEIN, TALI (SLP)
Entity type:Individual
Prefix:
First Name:TALI
Middle Name:
Last Name:EPSTEIN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5247 WILSON MILLS RD # 126
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-3016
Mailing Address - Country:US
Mailing Address - Phone:216-223-8761
Mailing Address - Fax:309-423-4813
Practice Address - Street 1:23775 GREENLAWN AVE
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-1430
Practice Address - Country:US
Practice Address - Phone:216-223-8761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-16
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOND.2014316-SP235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist