Mrs Kathleen Ellen Derga, MACCC/SLP | |
435 W Liberty St, Medina, OH 44256-2221 | |
(216) 749-6650 | |
(330) 723-8920 |
Full Name | Mrs Kathleen Ellen Derga |
---|---|
Gender | Female |
Speciality | Speech-language Pathologist |
Location | 435 W Liberty St, Medina, Ohio |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1174586838 | NPI | - | NPPES |
0148011 | Medicaid | OH | |
11658102 | Other | OH | CAQH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
235Z00000X | Speech-language Pathologist | SP.02499 (Ohio) | Primary |
Provider Name | Therapy In Motion |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1578708871 PECOS PAC ID: 0941363485 Enrollment ID: O20090420000123 |
Mailing Address | Practice Location Address |
---|---|
Mrs Kathleen Ellen Derga, MACCC/SLP 5000 Rockside Rd Ste 500, Independence, OH 44131-2178 Ph: (216) 459-2846 | Mrs Kathleen Ellen Derga, MACCC/SLP 435 W Liberty St, Medina, OH 44256-2221 Ph: (216) 749-6650 |
Morgan Lyn Sizler, M.A., CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 233 Jasper Ln, Medina, OH 44256 Phone: 330-321-1434 | |
Amy Witte, SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 435 W Liberty St, Medina, OH 44256 Phone: 216-408-5267 | |
Ms. Elizabeth Ann Hosek, M.A. CCC,SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 2400 Columbia Rd, Medina, OH 44256 Phone: 330-483-3131 | |
Mrs. Jennifer Lee Gibbs, M.A. Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 3637 Medina Rd, Suite 220, Medina, OH 44256 Phone: 330-952-0403 Fax: 330-952-0826 | |
Tinetta Lee Serdinak, M.A CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 3188 Stillwater Dr, Medina, OH 44256 Phone: 330-757-1302 | |
Madeline A Siket, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 3795 Walnut Hollow Dr, Medina, OH 44256 Phone: 330-416-3730 | |
Mrs. Barbara Lynn Prakup, M.A.,CCC-SP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 4099 Medina Rd, Medina, OH 44256 Phone: 330-725-7584 |