Provider Demographics
NPI:1386472397
Name:SUTER, MOLLY NICOLE (MS CF-SLP)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:NICOLE
Last Name:SUTER
Suffix:
Gender:F
Credentials:MS CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9140 US HIGHWAY 127
Mailing Address - Street 2:
Mailing Address - City:WEST UNITY
Mailing Address - State:OH
Mailing Address - Zip Code:43570-9791
Mailing Address - Country:US
Mailing Address - Phone:937-974-3054
Mailing Address - Fax:
Practice Address - Street 1:950 E OAK ST
Practice Address - Street 2:
Practice Address - City:WAUSEON
Practice Address - State:OH
Practice Address - Zip Code:43567-2223
Practice Address - Country:US
Practice Address - Phone:419-335-6581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOND.20242772-SP235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist