Provider Demographics
NPI:1992943435
Name:FRISZMAN, GINA
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:FRISZMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4710 STATE RD.
Mailing Address - Street 2:THEAPY IN MOTION, LLC
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44109-9532
Mailing Address - Country:US
Mailing Address - Phone:216-459-2846
Mailing Address - Fax:
Practice Address - Street 1:5273 BROADVIEW RD.
Practice Address - Street 2:THE THERAPY LINK
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44134
Practice Address - Country:US
Practice Address - Phone:216-749-6650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-21
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOND.2008153-SP235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH08429945Medicaid
OH000000217475OtherANTHEM BLUE CROSS AND BLUE SHIELD
OH08429945Medicaid