Provider Demographics
NPI:1962994798
Name:COLUMBUS AREA SPEECH THERAPY
Entity type:Organization
Organization Name:COLUMBUS AREA SPEECH THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:UJCICH
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:614-657-5673
Mailing Address - Street 1:3693 HILLIARD STATION RD
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-9336
Mailing Address - Country:US
Mailing Address - Phone:614-657-5673
Mailing Address - Fax:614-534-0976
Practice Address - Street 1:3693 HILLIARD STATION RD
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-9336
Practice Address - Country:US
Practice Address - Phone:614-657-5673
Practice Address - Fax:614-534-0976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-06
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH07016261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech