Provider Demographics
NPI:1972070746
Name:MASON, MARY FRANCES (MS, SLP-CCC)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:FRANCES
Last Name:MASON
Suffix:
Gender:F
Credentials:MS, SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12835 WOODTOWN RD
Mailing Address - Street 2:
Mailing Address - City:GALENA
Mailing Address - State:OH
Mailing Address - Zip Code:43021-9476
Mailing Address - Country:US
Mailing Address - Phone:614-562-9342
Mailing Address - Fax:740-965-9084
Practice Address - Street 1:12835 WOODTOWN RD
Practice Address - Street 2:
Practice Address - City:GALENA
Practice Address - State:OH
Practice Address - Zip Code:43021-9476
Practice Address - Country:US
Practice Address - Phone:614-562-9342
Practice Address - Fax:740-965-9084
Is Sole Proprietor?:No
Enumeration Date:2018-10-30
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP3417235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist