Provider Demographics
NPI:1609460666
Name:BUFFA, DEVIN ROSE (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:DEVIN
Middle Name:ROSE
Last Name:BUFFA
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 1:13901 QUAIL OVAL
Mailing Address - Street 2:
Mailing Address - City:NORTH ROYALTON
Mailing Address - State:OH
Mailing Address - Zip Code:44133-4119
Mailing Address - Country:US
Mailing Address - Phone:440-602-2825
Mailing Address - Fax:
Practice Address - Street 1:3650 GRAFTON RD
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:OH
Practice Address - Zip Code:44212-1804
Practice Address - Country:US
Practice Address - Phone:330-273-0485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-21
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH20201601235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist