MEDICARE: SPEECH CONNECTIONS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	2202007626	VA

General Provider Information

NPI Number	:	1013464627
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPEECH CONNECTIONS

Provider Business Mailing Address
First Line	:	4110 EAST PARHAM ROAD
Second Line	:	SUITE 101
City	:	HENRICO
State	:	VA
Zip	:	23228
Country	:	US
Telephone Number	:	804-672-8588
Fax Number	:	804-672-8587

Provider Business Practice Location Address
First Line	:	4110 E PARHAM RD
Second Line	:	SUITE 101
City	:	HENRICO
State	:	VA
Zip	:	23228-0018
Country	:	US
Telephone Number	:	804-672-8588
Fax Number	:	804-672-8587

Authorized Official
Title or Position	:	SPEECH PATHOLOGIST
Name	:	MRS. KATHY ALTER
Credential	:	M.S. CCC-SLP
Telephone Number	:	804-672-8588

Provider Enumeration Date	:	09/01/2016
Last Update Date	:	09/01/2016

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Directions to “SPEECH CONNECTIONS ” Practice Location

Language	Start Address	Practice Location

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