MEDICARE: AINE MAHAN

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	029817	NY
2	235Z00000X	Speech-Language Pathologist	SP.13945	OH
3	235Z00000X	Speech-Language Pathologist	7483	TN

General Provider Information

NPI Number	:	1134746274
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AINE MAHAN

Provider Business Mailing Address
First Line	:	1706 26TH AVE S
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37212-3307
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1706 26TH AVE S
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37212-3307
Country	:	US
Telephone Number	:	629-224-8627
Fax Number	:

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

Provider Enumeration Date	:	07/05/2020
Last Update Date	:	02/27/2024

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Directions to “ AINE MAHAN ” Practice Location

Language	Start Address	Practice Location

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