MEDICARE: MRS. RITA D THURMAN M.S.

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	1315	NC

General Provider Information

NPI Number	:	1083828420
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. RITA D THURMAN M.S.

Provider Business Mailing Address
First Line	:	3700 NATIONAL DR
Second Line	:	SUITE 219
City	:	RALEIGH
State	:	NC
Zip	:	27612-4842
Country	:	US
Telephone Number	:	919-571-0622
Fax Number	:	919-800-3365

Provider Business Practice Location Address
First Line	:	3700 NATIONAL DR
Second Line	:	SUITE 219
City	:	RALEIGH
State	:	NC
Zip	:	27612-4842
Country	:	US
Telephone Number	:	919-571-0622
Fax Number	:	919-800-3365

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2007
Last Update Date	:	01/02/2013

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