Provider Demographics
NPI:1811515000
Name:LOVERIDGE, NATASHA (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:LOVERIDGE
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1949 OH-59
Mailing Address - Street 2:SUITE 202
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1949 OH-59
Practice Address - Street 2:SUITE 202
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240
Practice Address - Country:US
Practice Address - Phone:133-084-6180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-14
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.12437235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist