MEDICARE: CARA RICHMAN

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	SLP010733	GA

General Provider Information

NPI Number	:	1114573136
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARA RICHMAN

Provider Business Mailing Address
First Line	:	205 S PALISADES DR
Second Line	:
City	:	SIGNAL MOUNTAIN
State	:	TN
Zip	:	37377-2922
Country	:	US
Telephone Number	:	423-637-2188
Fax Number	:

Provider Business Practice Location Address
First Line	:	37 BROCK DR
Second Line	:
City	:	LOOKOUT MOUNTAIN
State	:	GA
Zip	:	30750-2207
Country	:	US
Telephone Number	:	706-956-5898
Fax Number	:

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

Provider Enumeration Date	:	08/15/2019
Last Update Date	:	08/15/2019

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Directions to “ CARA RICHMAN ” Practice Location

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